Case 148: An 86-Year-Old Woman in the ICU History Diagnosis History This 86-year-old woman was transferred from her nursing home with severe diarrhea post amoxicillin therapy. On the day after admission, she became hypotensive and the following ECG was recorded: Diagnosis Ventricular tachycardia – ventricular rate 110/min In the 10 second rhythm strip of V1, …
Case 149: A 74-Year-Old Man Scheduled for Cardiac Surgery History Diagnosis ECG 2 ECG 2 Diagnosis ECG Comparison History This 74-year-old man with a history of coronary artery disease is scheduled to undergo aorto-coronary bypass surgery: Diagnosis Sinus rhythm, 58/min Left anterior fascicular block ECG 2 Two days after successful and uncomplicated aorto-coronary bypass surgery, …
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Case 150: A 53-Year-Old Man with an Abnormal ECG History Diagnosis History A 53-year-old man was referred to cardiology for an ECG abnormality discovered during an episode of left anterior chest pain. An exercise myocardial perfusion scan, echocardiogram, and chest X-ray were all normal. During 24-hour monitoring, the ECG abnormalities did not change: Diagnosis Type …
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Case 151: A 52-Year-Old Man who Fell History Diagnosis History This 52-year-old man was seen in the Emergency Department after an accidental fall. Investigation for head trauma was negative.A routine ECG was obtained. Diagnosis Dextrocardia The patient’s dextrocardia had incidentally been discovered after a chest X-ray in his twenties. Further assessment did not demonstrate any …
Case 152: A 66-Year-Old Woman with Chest Pain History Diagnosis ECG 2 ECG 2 Diagnosis History This 66-year-old woman with a history of hypertension is brought to the emergency department four hours after the onset of severe retrosternal chest pain, associated with dyspnea, diaphoresis and nausea: Diagnosis Sinus rhythm with successive ectopic ventricular complexes (accelerated idioventricular …
Case 153: A 65-Year-Old Man in the ICU History Diagnosis History This 65-year-old man with a significant smoking history is admitted to the ICU with pneumonia and severe hypoxemia requiring intubation: Diagnosis Atrial tachycardia, 174/min Right axis deviation rSR’ pattern in V1, consider right ventricular conduction abnormality A diagnosis of incomplete right bundle branch block …
Case 154: A 61-Year-Old Man with Infective Endocarditis History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 History This 61-year-old man is admitted with infective endocarditis of the mitral valve: Diagnosis Atrial flutter Complete heart block with a wide-QRS escape rhythm (right bundle branch block pattern) Ventricular rate 54/min When patients with atrial flutter develop …
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Case 155: A 69-Year-Old Woman in the Emergency Department History Diagnosis ECG 2 ECG 2 Diagnosis History This 69-year-old woman was brought to the Emergency Department because of the recent onset of episodes of presyncope: Diagnosis Sinus rhythm with third degree AV block Escape wide-QRS rhythm , rate 45/min The narrow-QRS complex at the beginning …
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Case 156: A 41-Year-Old Woman with a Prosthetic Mitral Valve History Diagnosis History This 41-year-old woman had been known to have severe mitral regurgitation secondary to mitral valve prolapse, and recently developed symptoms of congestive heart failure. Mitral valve repair was successfully carried out, and the following ECG was recorded one week later: Diagnosis Junctional …
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Case 157: A 73-Year-Old Man who had a Recent CABG History Diagnosis History This 73-year-old man is postoperative day 3 from an uncomplicated coronary artery bypass surgery: Diagnosis AV dissociation (sinus rhythm with accelerated idioventricular rhythm), followed by sinus rhythm with normal AV conduction Non-specific ST-T abnormality In the first half of the tracing, there …
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