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Canadian Journal of Rural Medicine
../../../ 1998

Country cardiograms case 12:
"I think this patient needs lidocaine. . . ."

Gordon Brock, MD, CCFP
Vydas Gurekas, MD, CCFP
Temiscaming, Que.

CJRM 1999;4(2):95


Correspondence to: Dr. Gordon Brock, 180, rue anvik, Box 760, Temiscaming QC J0Z 3R0; fax 819 627-3629

This paper has been peer reviewed.

© 1999 Society of Rural Physicians of Canada


"Country cardiograms" is a regular feature of the Canadian Journal of Rural Medicine. In each issue we will present an electrocardiogram and discuss the case in a rural context. Please submit cases to Ms Suzanne Kingsmill, Canadian Journal of Rural Medicine, Box 1086, Shawville QC JOX 2Y0.

Case presentation

This 49-year-old man, from "Elsewhereville" had a history of atrial fibrillation and was taking sotalol, 80 mg bid, and Entrophen, 300 mg every morning. He had had no cardiac symptoms for months. While vacationing in our town he started to have irregular and, it seemed to him, rapid palpitations. He was brought to the hospital, given oxygen and placed on a cardiac monitor.

His wife, who is an ICU nurse, noted intermittent wide beats on the cardiac monitor and thought he should be given lidocaine intravenously. The monitor did indeed show occasional single beats that appeared to be wide. The patient was comfortable and in no distress. The 12-lead electrocardiogram is shown.

What do you think about the wife's demand for lidocaine? See answer on page 110.