History of fatigue-malaise-palpitations and chest pain

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Reference no: EM133645189

Question

A 6 y.o. boy was admitted to the hospital with a history of fatigue, malaise, palpitations and chest pain. The boy has been followed by cardiologist for operated congenital heart disease (Tetralogy of Fallot); surgery was performed at the age of 1 year. Examination reveals a boy in no distress. Color of skin is normal with acrocyanosis developing on exertion. No erythema of the pharynx or lymphatic nodes changes is found. RR is 22, vesicular breath sounds with no crackles are audible on auscultation. HR is 84/min. On auscultation, heart sounds are loud and systolic murmur is heard along the left sternal border. The remaining physical findings are normal. CBC: Hb, g/L RBC, T/L WBC, G/L Bands, % Segm., % Eos., % Lym., % Mon., % Plat., G/L ESR, mm/h 141 4.4 5.8 1 49 4 44 2 236 8 ECG reveals multiply extrasystoles. QRS complex is deformed, with duration more than 0.12 sec, P wave is absent, T wave is negative.

1. Prove and formulate the diagnosis.

2. What kind of arrhythmia has developed?

3. What is the etiology of arrhythmia in this case?

Reference no: EM133645189

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