Case 61: A 46-Year-Old Man in the Cardiac Clinic History Diagnosis History A 46-year-old man with a 3 year history of coronary artery disease is seen in the cardiac clinic for a follow-up visit: Diagnosis Coarse atrial fibrillation, 86/min Inferior infarction, age undetermined Coarse atrial fibrillation with fibrillatory waves seen during the entire 10 …
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Case 62: A 69-Year-Old Man admitted for Coronary Angioplasty History Diagnosis ECG 2 ECG 2 Diagnosis History A 69-year-old man with known symptomatic coronary artery disease is admitted for angioplasty of his circumflex artery: Diagnosis Suspect lead error (Right Arm – Left Arm Reversal) Sinus rhythm, left bundle branch block Please, repeat the ECG. In …
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Case 63: A 54-Year-Old Woman in the Emergency Department History Diagnosis History A 54-year-old woman with a 6 month history of occasional retrosternal pain on exertion is seen in the Emergency Department complaining of oppressive anterior chest discomfort, dyspnea and palpitation: Diagnosis Atrial fibrillation with rapid ventricular response (168/min) Lateral myocardial infarction, age undetermined (40 …
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Case 64: A 58-Year-Old Man in the Coronary Care Unit History Diagnosis History A 58-year-old man is admitted to the coronary care unit with severe central anterior chest pain of 4 hour duration. This ECG tracing is recorded 2 hours after his admission: Diagnosis Sinus rhythm, 90/min Complete heart block,with escape junctional rhythm, 47/min Acute …
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Case 65: A 59-Year-Old man in the Cardiac Intensive Care Unit History Diagnosis History A 59-year-old man is in the Surgical Cardiac Intensive Care Unit two days after aorto-coronary bypass: Diagnosis Atrial fibrillation with rapid ventricular response (ventricular rate 132/min) Right bundle branch block ECG ID: E376
Case 66: An 89-Year-Old Man in the ICU History Diagnosis ECG 2 ECG 2 Diagnosis History An 89-year-old man with hypertension, diabetes and coronary artery disease suffered cardiac arrest at home. When the Emergency Medical Service arrived he was pulseless, but shortly afterwards there was spontaneous return of circulation. He is admitted to ICU and …
Case 67: A 64-Year-Old Man with a Slow Heart Rate History Diagnosis History A 48-year-old man recovering in hospital after repair of a dissected thoraco-abdominal aortic aneurysm is having periods of marked bradycardia but no episodes of syncope: Diagnosis Marked sinus bradycardia (sinus rate 37/min) AV dissociation, with an escape junctional rhythm, one AV capture, …
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Case 68: A 60-Year-Old Man with Frequent Chest Pain History Diagnosis History A 60-year-old man is admitted to the CCU with one week history of frequent episodes of anterior chest pain at rest and on mild exertion: Diagnosis Sinus rhythm with AV dissociation due to a competing accelerated junctional rhythm Ventricular rate 65/min One AV …
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Case 69: A 68-Year-Old Woman in the Emergency Department History Diagnosis History A 68-year-old woman has had mild stable angina for 5 years. She is presenting to the Emergency Department following an episode of palpitation, that she describes as a sensation of “her heart racing” for about 30 minutes. Her symptoms had subsided before arrival: …
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Case 70: A 41-Year-Old Man with Valvular Heart Disease History Diagnosis History A 41-year-old man is admitted with pneumonia and congestive heart failure. On examination evidence of valvular heart disease is discovered: Diagnosis Sinus rhythm Left atrial enlargement Right ventricular hypertrophy ST and T wave abnormality, consider anterolateral ischemia On admission the patient had evidence …
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