Case 138: A 64-Year-Old Man with Palpitations History Diagnosis ECG 2 History This 64-year-old man presents to the Emergency Department with palpitations. He reports a five-year history of paroxysmal tachycardia starting and ending suddenly, occurring approximately once a month, lasting usually 20-30 minutes, and associated with weakness, dizziness, and neck pulsations: Diagnosis Supraventricular tachycardia: AV …
Case 139: A 78-Year-Old Woman with Diabetes History Diagnosis History A 78-year-old woman with a history of diabetes and a three year history of mild stable angina presents for routine follow-up. Complete occlusion of the LAD has previously been demonstrated, with good collateral circulation. She also has moderately severe left ventricular dysfunction, with evidence of …
Case 140: A 60-Year-Old Man who Fainted History Diagnosis ECG 2 ECG 2 Diagnosis History This 60-year-old man presents to the Emergency Department following an episode of syncope at home, lasting less than one minute. He reports having suffered from a myocardial infarction four years prior, from which he had made a good recovery and …
Case 141: A 38-Year-Old Man with Severe Hepatosplenomegaly History Diagnosis ECG 2 History This 38-year-old man was admitted to hospital because of acute onset of right upper quadrant pain, fever, and drenching sweats. He was mildly jaundiced, with massive hepatomegaly and splenomegaly. His liver biopsy showed a high grade B-cell lymphoma replacing his liver parenchyma, …
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Case 142: A 57-Year-Old Man with Ischemic Cardiomyopathy History Diagnosis ECG 2 History This 57-year-old man is followed in the cardiac clinic for ischemic cardiomyopathy. He suffered from a myocardial infarction 14 years ago: Diagnosis Sinus rhythm – Left bundle branch block Possible anteroseptal myocardial infarction, age undetermined The presence of q waves in lead …
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Case 143: An 88-Year-Old Woman in the ICU History Diagnosis History This 88-year-old woman with a history of pulmonary tuberculosis, severe bullous emphysema, and pulmonary fibrosis was admitted to the intensive care unit with bronchopneumonia and acute respiratory insufficiency requiring intubation: Diagnosis Coarse atrial fibrillation with rapid ventricular response (136/min) Right bundle branch block Right …
Case 144: A 55-Year-Old Woman in the Neurosurgery ICU History Diagnosis History This 55-year-old woman had surgery two day ago for the removal of a left temporal lobe tumor. Postoperatively, her heart rate was noted to be slow: Diagnosis Marked sinus bradycardia (38/min) with sinus arrhythmia Escape junctional bradycardia with isorhythmic AV dissociation There is …
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Case 145: A 43-Year-Old Man in the Nephrology Clinic History Diagnosis History This 43-year-old man with diabetes, hypertension, and end-stage diabetic nephropathy on dialysis presents to the nephrology clinic for routine follow-up: Diagnosis Sinus rhythm Left atrial enlargement Left ventricular hypertrophy with repolarization abnormality ST elevation in V2 and V3, probably reciprocal to the “strain pattern” of …
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Case 146: A 54-Year-Old Man in the Cardiac Surgery ICU History Diagnosis History This 54-year-old man complains of chest pain one day after a successful bypass surgery: Diagnosis Sinus rhythm Acute pericarditis The ECGs of patients who have had cardiac surgery frequently show ECG findings of acute pericarditis in the first few days after the …
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Case 147: A 56-Year-Old Man in the CCU History Diagnosis History This 56-year-old man developed an arrhythmia one hour after his admission to the coronary care unit: Diagnosis Sinus rhythm with second degree AV block Mobitz I (4:3) Acute inferior myocardial infarction ECG ID: E230
