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Case 58: A 42-Year-Old Man Who Applied for Life Insurance

Practice Level 5

Case 58: A 42-Year-Old Man Who Applied for Life Insurance History Diagnosis History This 42-year-old accountant was referred because of ECG abnormalities discovered during a routine life-insurance assessment. He was asymptomatic and exercised regularly without discomfort. His blood pressure was normal. There was a very soft mid-systolic murmur at the left lower sternal border: Diagnosis …

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Case 60: A 58-Year-Old Man with Unstable Angina

Practice Level 5

Case 60: A 58-Year-Old Man with Unstable Angina History Diagnosis ECG 2 ECG 2 Diagnosis History A 58-year-old man is admitted with unstable angina. Chest pain continued to occur despite maximal therapy. A few hours before his scheduled aorto-coronary bypass surgery, the patient developed palpitation, dyspnea and angina: Diagnosis Ventricular tachycardia, 126/min Capture and fusion …

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Case 61: A 63-Year-Old Woman with Dilated Cardiomyopathy

Practice Level 5

Case 61: A 63-Year-Old Woman with Dilated Cardiomyopathy History Diagnosis ECG 2 ECG 2 Diagnosis History This 63-year-old woman, known for the past 5 years to have a dilated cardiomyopathy of unknown etiology, is brought to the Emergency Department, complaining of sudden onset of rapid palpitation and dyspnea: Diagnosis Ventricular tachycardia with 2:1 retrograde ventriculo-atrial …

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Case 62: A 53-Year-Old man with Palpitation and Faintness

Practice Level 5

Case 62: A 53-Year-Old man with Palpitation and Faintness History Diagnosis ECG 2 ECG 2 Diagnosis History This 53-year-old man was at a party when he suddenly experienced weakness, faintness and rapid palpitation. He had been well and normally active. He denies excessive alcohol intake: Diagnosis Wide QRS tachycardia (rate 163/min, QRS duration 144 msec) …

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Case 63: A 61-Year-Old Woman with Severe Heart Failure

Practice Level 5

Case 63: A 61-Year-Old Woman with Severe Heart Failure History Diagnosis History This 61-year-old woman with known Adriamycin-induced cardiomyopathy as a result of treatment for lymphoma is in the ICU with severe heart failure that has required prolonged ventilation: Diagnosis Multifocal atrial tachycardia, rate 140/min One premature ventricular complex Left ventricular hypertrophy with QRS widening …

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Case 65: An 18-Year-Old Man in the Respirology Clinic

Practice Level 5

Case 65: An 18-Year-Old Man in the Respirology Clinic History Diagnosis ECG 2 History An 18-year-old student is seen in the respirology clinic because of exacerbation of chronic chest disease due to primary ciliary dyskinesia. CT scans had shown diffuse bronchiectases in both lungs and pansinusitis: Diagnosis Negative P wave in I, right axis deviation, rS …

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