Case 128: A 79-Year-Old Woman with Heart Failure History Diagnosis History This 79-year-old woman with heart failure with a reduced ejection fraction is seen in the cardiac clinic for follow-up. She is stable and euvolemic, and denies any presyncope: Diagnosis Sinus rhythm with possible sino-atrial block (Mobitz I) Left bundle branch block The P waves …
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Case 129: A 29-Year-Old Woman with Palpitations History Diagnosis ECG 2 History This 29-year-old woman presents to the Emergency Department complaining of palpitations, presyncope, and dyspnea. She reports experiencing palpitations for the past 14 years, that have a sudden-onset, are rapid and regular, and occur twice a year. She also states that they are accompanied by chest …
Case 130: A 40-Year-Old Man with a Patent Ductus Arteriosus History Diagnosis History This 40-year-old man with a known patent ductus arteriosus presents with increasing dyspnea on exertion over the past five years: Diagnosis Sinus rhythm Right atrial enlargement Right bundle branch block plus right ventricular hypertrophy (RBBB and RVH) with repolarization abnormality This patient …
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Case 131: A 68-Year-Old Woman with Heart Failure History Diagnosis History This 68-year-old woman is in hospital for treatment of severe congestive heart failure secondary to rheumatic valvular disease: Diagnosis Atrial fibrillation – ventricular rate 66/min Incomplete right bundle branch block (iRBBB) ST depression, prominent U waves, with marked QT-U prolongation (QTU 612ms – cQTU …
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Case 132: A 58-Year-Old Man with Dyspnea on Exertion History Diagnosis ECG 2 Diagram History A 58-year-old man with diabetes is seen by his family physician because of the recent onset of dyspnea on exertion Diagnosis Right arm – right leg lead reversal – this precludes the interpretation of the limb leads The chest leads …
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Case 133: A 48-Year-Old Man with Chest Pain History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History This 48-year-old man with a history of untreated hyperlipidemia and smoking presented to the Emergency Department with severe anterior chest pain for the past 70 minutes: Diagnosis Sinus rhythm with marked sinus arrhythmia Inferior …
Case 134: A 62-Year-Old Woman with Palpitations History Diagnosis ECG 2 ECG 2 Diagnosis History This 62-year-old woman presents to the Emergency Department with palpitations, dyspnea and weakness. These palpitations have occured once a year since she was 22, with a sudden onset, and have typically resolved with Valsalva. Recently, they had been occurring every …
Case 135: An 80-Year-Old Woman with Pneumonia History Diagnosis History This 80-year-old woman with chronic obstructive lung disease has been admitted to the medical ICU with pneumonia: Diagnosis Multifocal Atrial Tachycardia (MAT) Left axis deviation Non-specific ST and T abnormality Besides the presence of P waves with a different morphology, an important characteristic feature of …
Case 136: A 63-Year-Old Woman with a Prosthetic Aortic Valve History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History Six months ago, this 63-year-old man underwent replacement of his aortic valve for severe calcific aortic stenosis. He did well, and was symptom-free until one week ago when he started experiencing weakness, fatigue …
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Case 137: A 68-Year-Old Man after Bypass Surgery History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 History A 68-year-old man with severe angina underwent bypass surgery to the left anterior descending and circumflex arteries. The following ECG was recorded shortly after the operation, upon transfer to the ICU: Diagnosis Sinus bradycardia, 54/min Inferior infarct, …
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