PEA ECG refers to the ECG findings associated with Pulseless Electrical Activity (PEA). PEA is not a specific ECG rhythm but rather a clinical state.
Understanding Pulseless Electrical Activity (PEA)
PEA, also known as electromechanical dissociation, is a critical medical condition where the heart shows electrical activity on an ECG, but the patient has:
- Unresponsiveness: The patient is not conscious or alert.
- Impalpable Pulse: No pulse can be felt. This indicates the heart is not effectively pumping blood.
Essentially, the ECG shows a rhythm that should be producing a pulse, but it isn't. It's a disconnect between the heart's electrical activity and its mechanical function. According to provided reference, PEA is characterized by unresponsiveness and impalpable pulse in the presence of sufficient electrical discharge.
PEA ECG: What You'll See
The "PEA ECG" isn't one specific pattern. Instead, it's about what should be happening versus what is happening. The ECG will show some organized electrical activity that typically would generate a pulse, but the clinical assessment reveals no pulse.
Possible ECG Rhythms in PEA:
The ECG rhythm during PEA can be any of the following (excluding ventricular fibrillation (VF) or ventricular tachycardia (VT) without a pulse):
- Sinus Rhythm: The heart's natural pacemaker is firing, but the contractions are too weak to produce a pulse.
- Bradycardia: A slow heart rate (less than 60 bpm) with some kind of electrical activity.
- Idioventricular Rhythm: A slow rhythm originating from the ventricles.
- Supraventricular Tachycardia (SVT): A fast heart rhythm originating above the ventricles.
Key Considerations:
- PEA is a clinical diagnosis: The ECG is just one part. The absence of a pulse is crucial.
- Treat the underlying cause: Finding and treating the underlying cause of PEA is critical for patient survival. The ECG rhythm itself is secondary to addressing the root problem. Common causes of PEA include hypovolemia, hypoxia, hydrogen ion excess (acidosis), hyper-/hypokalemia, hypothermia, toxins, tamponade (cardiac), tension pneumothorax, thrombosis (coronary or pulmonary), and trauma.
