Holter Monitoring Scenario in NICL Malaysia

Holter

1. Holter Monitoring Scenario (NICL) PPP Suliana, PPP Mustaqimah , PPP Lisha

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3. Scenario A 14 y/o , female NKMI Presented to nearest Klinik Kesihatan with c/o frequent episodes of palpitation happens usually during school hours Otherwise no syncopal attack, no SOB, no chest pain No h/o admission No family history of cardiac arrest and sudden death before 40 y/o

4. Vital sign B/P: 112/75 mmHg ,SPO2: 99% ECG: Sinus tachycardia, Heart rate 125 bpm

5. So what’s next? Refer to PAEDIATRIC CARDIOLOGIST

6. ECHO findings: Situs solitus , levocardia Normal pulmonary and systemic venous drainage Balance chamber AV/VA concordance IAS/IVS intact No MR/TR No LVOTO/RVOTO No AR/PR Normal coronary origins with normal size Confluent PA branches, no PDA Left arch, no CoA Single right SVC Good ventricular systolic function, LVEF 76%

7. o/e: pink, not teachypneic normal vital sign parameters ECG : Normal SR , HR 85bpm

8. So what’s next? Refer to PNICL for holter assessment

9. and here comes the patient.. we’ll be using Cardioscan (patch)

10. Baseline

11. Longest R-R

12. Max HR

13. Min HR

14. Patient triggered event

15. Normal Sinus Rhythm

16. Minutes before and after triggered event

17. So what’s next? TCA PRN Advice to go to nearest kk or ED if happen to have palpitaion again.

18. Thank you