Clinical Decision Making – Veterinary ECG Quiz

Dog - Shih tzu (Recorded with Beecardia)

11 years • Male • Evaluated as part of a pre-anesthetic screen

Question

What is the significance of this rhythm, and does it call for rhythm-specific treatment before anesthesia?

It is sinus arrhythmia, a normal variant - no rhythm-specific treatment or delay is needed.

It is atrial fibrillation - rate control should be established before anesthesia.

It is frequent ventricular ectopy - antiarrhythmic therapy is warranted before anesthesia.

It is second-degree AV block - a pacing evaluation is needed before anesthesia.

Dog - Miniature Schnauzer (Recorded with Beecardia)

3 years • Female • ECG recorded shortly after administration of intravenous atropine

Question

Which statement about this recording is TRUE?

The dominant rhythm is sinus in origin, so the rate itself needs no rhythm-specific treatment.

The dominant rhythm arises outside the sinus node and calls for antiarrhythmic therapy.

The early pauses with escape beats indicate pathologic AV block that needs a pacing evaluation.

The same sustained rate in a calm, unmedicated dog at rest would be equally unremarkable.

Dog - Boxer (Recorded with Beecardia)

9 years • Female

Question

Counting the ectopic beats through this tracing, how is the ventricular ectopy best classified?

Ventricular couplets

Isolated single ventricular premature complexes

Ventricular triplets

A run of ventricular tachycardia

Dog (Recorded with Beecardia)

Female

Question

Based on this resting ECG, what is the most appropriate next step for this dog?

Reassure the owner; no further evaluation is needed

Start antiarrhythmic therapy to suppress the ectopic beats

Echocardiography to screen for underlying structural heart disease

Hospitalize for continuous ECG monitoring and urgent treatment

Dog - Australian Shepherd (Recorded with Beecardia)

7 years

Question

Wide premature complexes interrupt this dog's sinus rhythm. How are these complexes best characterized?

Uniform VPCs arising from the right ventricle

Uniform VPCs arising from the left ventricle

Multiform VPCs from several ventricular foci

Supraventricular beats conducted with aberrancy

Dog - Goldendoodle (Recorded with Beecardia)

10 years • Female • Previously diagnosed with dilated cardiomyopathy, probably secondary to a grain-free diet; occasional cough. Receiving cardiac medication

Question

How should this rhythm be interpreted for this dog, and what should happen next?

Continue the current medications - the rate felt on auscultation is acceptable and the cough is unrelated.

Clinically significant here - assess the ventricular response rate and rule out congestive heart failure.

Prioritize restoring sinus rhythm, since the irregularity rather than the rate is what limits output.

Expected with dilated cardiomyopathy - recheck the rhythm at the routine three-month visit.

Dog - Great Dane (Recorded with Beecardia)

6 years • Male

Question

Ventricular premature complexes interrupt the sinus rhythm on this tracing. Given what the ectopy looks like here, what is the most appropriate next step for this patient?

Occasional ventricular beats like these are incidental in a dog this age and need no further evaluation

The ectopy is repeated and includes a short ventricular run, so echocardiography and Holter monitoring are warranted

The rhythm is immediately life-threatening and needs emergency antiarrhythmic therapy before anything else

The beats are benign because they are uniform, so a recheck ECG in several months is all that is needed

Dog - Labrador (Recorded with Beecardia)

10 years • Female

Question

Short runs of a second rhythm interrupt the sinus rhythm here. Given their rate, which term most precisely describes these runs?

Ventricular tachycardia

Sinus tachycardia

Supraventricular tachycardia

Accelerated idioventricular rhythm

Cat - DSH (Recorded with Beecardia)

14 years • Male

Question

Third-degree AV block is present. Based on the escape rhythm in this tracing, which course of action is most appropriate?

The escape rate is too slow to sustain this cat; urgent pacing evaluation is needed.

Holter monitoring to quantify the ventricular ectopy is the most useful next step.

This degree of block is incidental in an older cat; no further evaluation is needed.

The escape rate supports perfusion for now; evaluate for underlying myocardial disease by echocardiography.

Dog (Recorded with Beecardia)

Female

Question

Based on the ectopy early in this recording, what is the most appropriate next step for this dog?

Schedule a Holter recording and recheck in a few weeks

Attribute the fast rate to stress and reassess once the dog is calm

Begin in-hospital antiarrhythmic therapy now with continuous ECG monitoring

No treatment needed; recheck at the next wellness visit

Quiz: Clinical Decision Making

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