Case 68: A 68-Year-Old Man with Mitral Valve Disease History Diagnosis ECG 2 ECG 2 Diagnosis Explanatory Diagram History This 68-year-old man with known rheumatic valvular disease had a mitral commissurotomy 7 years ago. He has moderate mitral stenosis and regurgitation. He is followed in the arrhythmia clinic: Diagnosis Right arm-right leg lead reversal – This …
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Case 69: A 25-Year-Old Woman with Episodes of Palpitation History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis ECG 4 ECG 4 Diagnosis History This 25-year-old woman in the past 4 years has had 5-6 episodes of fast regular palpitation, starting and ending abruptly, lasting 45-60 minutes: Diagnosis Sinus rhythm Wolff-Parkinson-White EP studies demonstrated …
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Case 70: A 67-Year-Old Man with Congestive Heart Failure History Diagnosis ECG 2 ECG 2 Diagnosis History This 67-year-old man who suffered from a myocardial infarction 3 year ago has been admitted for treatment of congestive heart failure: Diagnosis Probably sinus tachycardia with first degree AV block (PR = 400 msec.) Anterior infarction Comment: The P …
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Case 71: A 32-Year-Old Woman in the Arrhythmia Clinic History Diagnosis History This 32-year-old woman is referred by her family physician because of almost constant palpitation during the past 2-3 months and recent onset of dyspnea on mild to moderate exertion: Diagnosis Nearly-incessant supraventricular rhythm – rate 100/min (upper strips – note paper speed 12.5mm/sec) – 80/min …
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Case 72: A 51-Year-Old Man in the ICU History Diagnosis History This 51-year-old man, who had a left pneumonectomy 2 years ago, is in the Intensive Care Unit with pneumonia: Diagnosis Sinus tachycardia Right atrial enlargement Right ventricular hypertrophy with repolarization abnormality T wave abnormality, consider lateral ischemia Comments: There are findings of right atrial enlargement …
Case 73: A 77-Year-Old Woman with Chest Pain and Dyspnea History Diagnosis ECG 2 ECG 2 Diagnosis History This 77-year-old woman had a myocardial infarct 9 years ago. She made a good recovery and was stable until 1 day before admission, when she developed severe crushing anterior chest pain at about 7 PM. Pain continued …
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Case 74: A 21-Year-Old Man with Palpitation History Diagnosis History This 23-year-old man has complained of palpitation since his early teens. His exercise tolerance is normal. He has been followed in the cardiac clinic: Diagnosis Sinus rhythm with Mobitz I second degree AV block and junctional escape complexes ST elevation compatible with early repolarization Comment: Congenital second …
Case 75: A 61-Year-Old Man with Endocarditis History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History This 61-year-old man with multiple serious medical problems is referred to the Emergency Department by his family physician. He has had a fever for one week and his blood cultures are positive for streptococcus viridans. …
Case 76: A 38-Year-Old Man with Palpitation History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History This 38-year-old male computer analyst is presenting at the Emergency Department complaining of palpitation and feeling lightheaded. He had experienced 3 similar episodes in the past 5 years for which he was given Adenosine IV …
Case 77: A 30-Year-Old Man with Non-specific Symptoms History Diagnosis History This 30-year-old factory worker is referred because of numerous nonspecific symptoms (dyspnea on exertion, rapid palpitation of gradual onset and offset, lightheadedness, sharp localized precordial pain). The ECG is abnormal, and there are no evidence of structural heart disease by echocardiography: Diagnosis Sinus Rhythm …
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