Case 69: A 48-Year-Old Man in the Cardiac Clinic
History
Diagnosis
History
A 48-year-old man is referred to the cardiac clinic for a two-year history of dyspnea on exertion and occasional palpitations:
Diagnosis
- Sinus rhythm
- Frequent premature ventricular complexes (with retrograde atrial capture)
- Septal infarction, age undetermined (poor R wave progression in V1-V3; the second QRS complex in lead V2 has a QS pattern)
The echocardiogram showed LV dilation with diffuse hypokynesis (LV ejection fraction 30%). A coronary angiogram was normal. Conclusion: dilated cardiomyopathy. The ECG findings justify the diagnosis of septal infarction (which is false-positive).
ECG ID: E548