Case 71: A 60-Year-Old Woman with Scleroderma History Diagnosis History A 60-year-old woman with a 10 year history of scleroderma is presenting to the Clinic: Diagnosis Sinus rhythm Left atrial enlargement Right axis deviation Right ventricular hypertrophy Non-specific ST and T abnormality The patient had scleroderma with severe pulmonary hypertension (pulmonary artery pressure 105 mmHg) …
Case 72: A 73-Year-Old Woman in the Cardiac Clinic History Diagnosis ECG 2 ECG 2 Diagnosis History A 73-year-old woman with history of hypertension and mild stable angina is seen for a routine assessment: Diagnosis Sinus bradycardia, 50/min Left anterior fascicular block (LAFB) Right bundle branch block (RBBB) RBBB plus LAFB (Bifascicular block) ECG 2 …
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Case 73: A 82-Year-Old Woman Who Fainted History Diagnosis History This 82 year old woman fainted suddenly while at home. She recovered consciousness after a few minutes and was brought by ambulance to the Emergency department. She appeared drowsy and confused. Diagnosis Sinus rhythm with complete heart block Very slow ventricular escape rhythm (19/min) ECG …
Case 74: A 75-Year-Old Man in Cardiogenic Shock History Diagnosis History A 75-year-old man, hypotensive following an acute myocardial infarction, has developed tachycardia and a further drop in blood pressure: Diagnosis Ventricular tachycardia, rate 312/min This pattern of VT is often referred to as “ventricular flutter”: regular continuous wide sine waves, with no distinction between …
Case 75: A 63-Year-Old Woman in the Intensive Care Unit History Diagnosis ECG 2 ECG 2 Diagnosis History A 63-year-old woman with a history of alcoholic cirrhosis and chronic obstructive lung disease is admitted to the ICU with severe pneumonia and sepsis with sudden onset of tachycardia and hypotension: Diagnosis Wide QRS tachycardia – Ventricular tachycardia Left bundle branch …
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Case 76: A 78-Year-Old Man with Severe Aortic Stenosis History Diagnosis History A 78-year-old man is admitted for investigation of severe aortic stenosis: Diagnosis Sinus rhythm Left axis deviation Left bundle branch block A commonly asked QUESTION is: “Why in this case of left bundle branch block the QRS in leads V5 and V6 is negative, instead …
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Case 77: A 61-Year-Old Man in the Surgical Recovery Room History Diagnosis ECG 2 History A 61-year-old man with a past history of episodes of paroxysmal palpitation is in the recovery room after trans-uretral prostate resection: Diagnosis Supraventricular tachycardia AV nodal Re-entrant Tachycardia (AVNRT) (Rate 152/min) ECG 2 There was no response to vagal stimulation …
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Case 78: A 66-Year-Old Woman with Palpitation and Faintness History Diagnosis ECG 2 ECG 2 Diagnosis History A 66-year-old woman with a history significant for heavy smoking and chronic alcohol use and dyspnea on mild exertion for the past 3 years is presenting to the Emergency Department with palpitation, faintness and dyspnea of 1 hour …
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Case 79: A 84-Year-Old Woman in the Medical ICU History Diagnosis History A 84-year-old woman with a long history of chronic obstructive pulmonary disease and asthma is admitted to the ICU with pneumonia: Diagnosis Multifocal atrial tachycardia (MAT), 138/min Left axis deviation Non-specific ST and T wave abnormality The computer program misdiagnosed the arrhythmia as …
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Case 80: A 51-Year-Old Man with Palpitation History Diagnosis History A 51-year-old man is complaining of palpitation, that he describes as a sensation of isolated “thumps” in his anterior chest: Diagnosis Sinus rhythm with frequent blocked premature atrial complexes (PAC) Ventricular rate 43/min ECG ID: E323
