Case 9: A 79-Year-Old Woman in the Cardiac Surgical ICU
History
Diagnosis
ECG 2
ECG 2 Diagnosis
History
A 79-year-old woman is in the cardiac surgical ICU, one week following aorto-coronary bypass surgery. The post-operative course has been complicated by pneumonia and respiratory failure, requiring intubation:
Diagnosis
- Pseudo-flutter-waves artifacts, rate 480/min
- The artifacts preclude the rhythm diagnosis
- Regular wide-QRS rhythm, with right bundle branch block pattern. Ventricular rate 69/min
ECG 2
The following ECG is recorded one day later. The condition of the patient remains unchanged, but stable:
ECG 2 Diagnosis
- Unusual P wave axis, consider ectopic atrial rhythm
- Right bundle branch block
ECG ID: E746