ecgmadesimple, Author at ECG Made Simple

Case 168: A 70 Year-Old Man in the Emergency Room with Palpitations

Case 168: A 70 Year-Old Man in the Emergency Room with Palpitations History Diagnosis History A 70 year-old man is seen in the emergency room complaining of palpitations for the last few hours. Vitals are stable. His 12-lead ECG is shown below: Diagnosis Sinus Rhythm, 80/min Frequent and consecutive premature atrial complexes (several are annotated …

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Case 169: A 74 Year-Old Man in the Cardiovascular Surgery ICU

Practice Level 4

Case 169: A 74 Year-Old Man in the Cardiovascular Surgery ICU History Diagnosis History A 74 year-old man is stable after recent cardiac surgery in the ICU. The following ECG is done just prior to his transfer to the cardiac surgery ward. Diagnosis Sinus rhythm, 90/min Non-conducted premature atrial complexes Comment: The non-conducted PACs are …

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Case 170: A 74 Year-Old Man in MSICU with Pneumonia

Practice Level 4

Case 170: A 74 Year-Old Man in MSICU with Pneumonia History Diagnosis History A 74 year old man with history of implanted pacemaker is admitted to the medical surgical ICU with community acquired pneumonia. His ECG is shown below: Diagnosis Atrial (AAI) pacing at rate 63/min Prolonged AV conduction Right Bundle Branch Block Left Anterior …

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Case 1: A 65-Year-Old Man with Previous Bypass Surgery

Practice Level 5

Case 1: A 65-Year-Old Man with a Previous Bypass Surgery History Diagnosis History A 65-year-old man with a previous history of bypass surgery presents to the family doctor’s office, complaining of new fatigue: Diagnosis Atrial Flutter (AFL) with occasional paced QRS complexes and pseudofusion beats Left bundle branch block ECG ID: E779

Case 2: A 52-Year-Old Man in ER with Palpitations

Practice Level 5

Case 2: 52-Year-Old-Man in ER with Palpitations ECG Diagnosis ECG 2 ECG 2 Diagnosis ECG A 52-year-old man with longstanding history of palpitations presents with an episode of palpitations that is more intense and of longer duration than his previous episodes: Diagnosis Atrial Fibrillation Preexcitation Likely left posterior accessory pathway ECG 2 This ECG is …

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Case 3: A 43-Year-Old Man with Palpitations

Practice Level 5

Case 3: A 43 Year-Old Man with Palpitation History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History A 43-year-old man with episodes of rapid palpitation occurring every few weeks, often caused by exercise and accompanied by dyspnea and weakness that usually subsides spontaneously after 15-20 minutes is presenting to the emergency department one hour after …

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Case 4: An 81-Year-Old Man in the Pacemaker Clinic

Practice Level 5

Case 4: An 81-Year-Old Man in Pacemaker Clinic History Diagnosis History An 81-year-old man with a pacemaker is in the operating room for shoulder surgery. Pacemaker device was “reprogrammed” just prior to surgery: Diagnosis Sinus rhythm with VOO pacing (asynchronous mode with no ventricular sensing) – this mode was likely chosen to prevent inappropriate pacemaker inhibition …

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Case 5: A 68-Year-Old Man in the Emergency Room

Practice Level 5

Case 5: A 68-Year-Old Man in the Emergency Room History Diagnosis History A 68-year-old man presents to the emergency room with palpitations. He has a previous history of hypertension and syncope with pacemaker implantation 3 years ago: Diagnosis Underlying atrial tachycardia (red arrows) – may be atrial flutter Native complexes conducted with left bundle branch …

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Case 6: A 72-Year-Old Man in Pacemaker Clinic

Practice Level 5

Case 6: A 72-Year-Old Man in Pacemaker Clinic History Diagnosis History A 72-year-old man presents to pacemaker clinic for routine assessment. He complains of feeling weaker now than on his previous visit: Diagnosis Sinus rhythm with complete heart block VVI pacemaker with adequate sensing and capture Single isolated premature ventricular complex ECG ID: E781

Case 7: A 64-Year-Old Man in Pacemaker Clinic

Practice Level 5

Case 7: A 64-Year-Old Man in Pacemaker Clinic History Diagnosis History A 64-year-old man presents to the pacemaker clinic for routine assessment. He is asymptomatic: Diagnosis Dual chamber pacemaker (as evidenced by two pacemaker spikes on 3rd QRS complex) with intermittent atrial undersensing lead V1 is disconnected for first 2 seconds of recording Poor R-wave …

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