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    Default ekg change s/p c-section...what happened?

    the pictures added to this thread were NOT from patient. I have searched exhaustively for a similar rhythm but wound up doing a cut/paste job, photo with phone sent to my email and downloaded. LOL.

    Case:

    32, F, 5'5, 70kg, previous c-section x1 scheduled for repeat c-section.

    PMH: none
    SH: neg. for tob, etoh, illicit
    PSH: ORIF rt ankle 10 years ago. no GA complications.
    EKG: NSR, textbook, HR=83

    Epidural placed in preop holding area. 1 attempt, LOR w/ saline at 5cm. catheter secured at 10cm. neg. test dose. T4 level obtained (2% lido w/ epi + 100 mcg Fentanyl. Total 15ml given.

    Taken to OR, monitors on, NC2L, surgical stimulation negative.

    C-section proceeds.

    Baby boy extracted (9/9 apgars) everything is fine.

    immediately after delivery, she tells me that she has a some pressure in her chest. EKG rhythm is high 90's and the waveform has changed. (I have a attached photo)

    I call the MDA to ask him what he thinks (will share later). We do not intervene because other than the mild/mod chest pain/pressure she is asymptomatic. BP and HR remain stable. 12 lead EKG ordered to be done in PACU.

    rhythm lasted approx 10-15 minutes. On arrival to PACU, EKG is NSR - textbook - HR: 100 - chest pain GONE.



    NOTE: the crappy green photo I created is the best replica of what her 'new' rhythm looked like in LEAD II. (only 3 leads avail in the OB OR)


    so, questions?

    what happened?
    Attached Images Attached Images

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