Case 68: A 57-Year-Old Man with Chest Pain History Diagnosis History A 57-year-old man presents with recurrent episodes of sharp left lower chest pain, lasting 5-10 seconds: Diagnosis Sinus rhythm, 71/min ST elevation, compatible with early repolarization ECG ID: E548
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 …
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Case 70: A 33-Year-Old Man in the Cardiac Clinic History Diagnosis History This 33-year-old man had been referred because of recurrent episodes of sharp localized pain in his left lower anterior chest, lasting from a few seconds to one minute: Diagnosis Sinus rhythm, 61/min ST elevation compatible with early repolarization (a normal variant) In favour …
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Case 71: A 78-Year-Old Woman in Congestive Heart Failure History Diagnosis History This 78-year-old woman with a previous history of rheumatic fever and an associated heart murmur presents to the hospital in severe congestive heart failure: Diagnosis Atrial fibrillation – Ventricular rate 84/min Right axis deviation Incomplete right bundle branch block (iRBBB) Biventricular hypertrophy Right …
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Case 72: A 58-Year-Old Man Recovering from Spinal Surgery History ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History This 58-year-old man was admitted after an accidental fall, and underwent urgent spinal surgery. This normal ECG was recorded during the pre-op assessment: ECG 2 On postoperative day 5, the patient suddeny became severely …
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Case 73: A 59-Year-Old Man in the Emergency Department History Diagnosis ECG 2 ECG 2 Diagnosis History This 59-year-old man with severe peripheral vascular disease was in the pre-anaesthesia clinic for assessment prior to his admission for vascular surgery. It was noted that his pulse was very rapid and irregular, despite him being asymptomatic. He …
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Case 74: A 61-Year-Old Man with Angina History Diagnosis History This 61-year-old man is admitted to the cardiac ward with angina: Diagnosis Sinus rhythm Chest lead misplacement (V1-V3 lead reversal) ST elevation in V1-V4 – Consider early repolarization or injury (clinical assessment is indicated) The finding of a diphasic (plus-minus) P wave in V3 and …
Case 75: A 25-Year-Old Woman in the ICU History Diagnosis History This 25-year-old woman with chronic respiratory failure and hypoventilation secondary to kyphoscoliosis and restrictive lung disease is admitted to the Intensive Care Unit with pulmonary aspergillosis: Diagnosis Sinus tachycardia 110/min Biatrial enlargement Right axis deviation Right ventricular hypertrophy Diffuse T wave abnormality The presence …
Case 76: A 53-Year-Old Man in Respiratory Distress History Diagnosis History This 53-year-old man with a history of heavy smoking and longstanding obstructive lung disease has been admitted to the medical ICU in severe respiratory distress with reduced air entry and diffuse wheezes bilaterally: Diagnosis Sinus rhythm, 98/min. Right atrial enlargement RBBB and RVH (Right …
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Case 77: An 81-Year-Old Woman with Severe Dyspnea History Diagnosis History This 81-year-old woman with chronic obstructive lung disease presents to the Emergency Department with increasing dyspnea and wheezing: Diagnosis Multifocal atrial tachycardia 160/min Occasional aberrantly conducted QRS complexes This tracing illustrates the classical features of Multifocal Atrial Tachycardia (MAT), where the P waves originate …
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