Case 48: A 66-Year-Old Man with Severe Dyspnea History Diagnosis History This 66-year-old man is in the Emergency Department with acute exacerbation of severe chronic obstructive lung disease and emphysema: Diagnosis Sinus rhythm, 95/min. Biatrial enlargement Markedly superior axis deviation (negative inferior leads with isoelectric lead I makes it difficult to determine if the superior …
Case 49: A 69-Year-Old Woman in the Cardiac Surgical ICU History Diagnosis History A 69-year-old woman is in the Cardiac surgical ICU one day after aortic valve replacement because of severe aortic stenosis. Pre-op coronary angiography is normal: Diagnosis Sinus rhythm, 75/min, with AV dissociation due to a competing accelerated junctional rhythm (ventricular rate 82/min) One …
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Case 50: A 56-Year-Old Woman with a Heart Murmur History Diagnosis History This 56-year-old woman was discovered to have a heart murmur in her teens. She was told that “she was born with it”. In the past 10 years she had developed increasing dyspnea on exertion, moderate cyanosis and finger clubbing: Diagnosis Sinus rhythm Biatrial …
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Case 51: A 69-Year-Old Man with Ischemic Cardiomyopathy History Diagnosis History This 69-year-old man with ischemic cardiomyopathy is in the cardiac surgical ICU following aorto-coronary bypass: Diagnosis Sinus rhythm Nonspecific intraventricular block ECG ID: E459
Case 52: A 76-Year-Old Woman Admitted with Congestive Heart Failure History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis Explanatory Diagram History A 76-year-old woman is admitted to the cardiac ward for treatment of heart failure: Diagnosis Sinus bradycardia, 55/min Right bundle branch block Anterior myocardial infarction, age undetermined ECG 2 The …
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Case 53: A 57-Year-Old Woman in the Emergency Room History Diagnosis History This 57-year-old diabetic hypertensive woman, with end-stage renal failure on hemodialysis, is seen in the Emergency Department with fever (38.6 C), nausea, weakness and diarrhea. Her medication includes Atenolol 100 mg daily: Diagnosis Marked sinus bradycardia (30/min) with junctional escape complexes (escape-capture bigeminy). …
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Case 54: A 65-Year-Old Woman in the Medical ICU History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 History A 65-year-old schizophrenic woman, known to have obstructive lung disease, is admitted to the medical ICU with left lower lobe pneumonia and severe hypoxia: Diagnosis Sinus tachycardia, 100/min Right axis deviation Low QRS voltage ECG 2 …
Case 55: A 45-Year-Old Man in the Emergency with Chest Pain History Diagnosis ECG 2 ECG 2 Diagnosis Compare ECG 1 and 2 ECG 3 ECG 3 Diagnosis Compare ECG 2 and 3 History This 45-year-old man with a longstanding history of diabetes, hypertension, dislipidemia and psychiatric illness is seen in the Emergency Department complaining …
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Case 56: A 64-Year-Old Woman in Cardiac Clinic History Diagnosis History This 64-year-old woman is seen in the cardiac clinic for a yearly follow-up. She had an anterior infarction 5 years ago and has made a good recovery. No cardiac symptoms during normal activity. Occasional brief episodes of dizziness. No history of syncope: Diagnosis …
Case 57: A 41-Year-Old Man in the Emergency Department History Diagnosis ECG 2 ECG 2 Diagnosis History This 41-year-old man known to have a dilated cardiomyopathy for several years is seen in the Emergency Department complaining of dyspnea and weakness, starting suddenly 1 hour earlier: Diagnosis Polymorphic ventricular tachycardia, rate 180/min. After the first 9 …
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