ecgmadesimple, Author at ECG Made Simple

Case 78: A 35-Year-Old Machine Operator with Palpitation

Case 78: A 35-Year-Old Machine Operator with Palpitation History Diagnosis History This 35-year-old machine operator started complaining one year ago of episodes of rapid “thumping” in his precordium every 2-3 months lasting 10-20 minutes: Diagnosis Sinus rhythm with sinus arrhythmia Wolff-Parkinson-White (WPW) Anteroseptal Accessory pathway Comment: An anteroseptal bypass tract was identified by EP studies. ECG …

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Case 79: A 69-Year-Old Man with Severe Lung Disease

Practice Level 5

Case 79: A 69-Year-Old Man with Severe Lung Disease History Diagnosis History This 69-year-old man with a long history of chronic obstructive lung disease and asthma is admitted because of worsening of his respiratory failure: Diagnosis Sinus tachycardia with occasional premature supraventricular complexes Right atrial enlargement Right bundle branch block Right ventricular hypertrophy Comment: This patient …

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Case 80: A 74-Year-Old Woman on the Respirology Ward

Practice Level 5

Case 80: A 74-Year-Old Woman on the Respirology Ward History Diagnosis History A 74-year-old woman with a long history of obstructive lung disease and asthma is on the respirology ward with severe bronchopneumonia: Diagnosis Multifocal atrial tachycardia (153/min) Frequent aberrantly conducted complexes (Ashman phenomenon) Non-specific ST and T abnormality Comment: There is a very rapid (153/min), …

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Case 81: A 77-Year-Old Man in the Coronary Care Unit

Practice Level 5

Case 81: A 77-Year-Old Man in the Coronary Care Unit History Diagnosis History A 77-year-old man is admitted to the Coronary Care Unit, where he is treated with fibrinolysis. This ECG is recorded 2 days later: Diagnosis Sinus rhythm Left axis deviation Intermittent right bundle branch block (2:1) Anteroseptal infarct, recent ECG ID: E266

Case 82: An 80-Year-Old Man in the EP Clinic

Practice Level 5

Case 82: An 80 Year-Old Man in the EP Clinic History Diagnosis History This 80-year-old man was in very good health until 8 years ago, when he had episodes of near-syncope and documented ventricular tachycardia, that did not require cardioversion. He was hospitalized and no evidence of structural heart disease was found. He was placed …

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Case 83: A 34-Year-Old Man with Endocarditis

Practice Level 5

Case 83: A 34-Year-Old Man with Endocarditis History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History This 34-year-old man, known to to have mitral valve prolapse with mild regurgitation, developed sudden cough and severe dyspnea. He is brought to the Emergency Department in acute pulmonary edema and has to be intubated …

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Case 84: A 42-Year-Old Woman After Ablation Procedure

Practice Level 5

Case 84: A 42-Year-Old Woman After Ablation Procedure History Diagnosis History This 42-year-old woman, who had frequent prolonged episodes of AVNRT, underwent an ablation procedure. This ECG tracing is recorded shortly after the end of the procedure: Diagnosis Sinus rhythm Second degree AV block Junctional escape complexes (escape-capture bigeminy) Ventricular rate 49/min ECG ID: E271

Case 85: A 75-Year-Old Woman in the Cardiac Surgical ICU

Practice Level 5

Case 85: A 75-Year-Old Woman in the Cardiac Surgical ICU History Diagnosis ECG 2 ECG 2 Diagnosis History This 75-year-old woman has undergone replacement of her aortic valve because of severe aortic stenosis. The preoperative ECG has shown left bundle branch block. The following tracing is recorded shortly after transfer from the OR to the cardiac …

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Case 86: A 48-Year-Old Patient who had Surgery for Tetralogy of Fallot

Practice Level 5

Case 86: A 48-Year-Old Patient who had Surgery for Tetralogy of Fallot History Diagnosis History The following ECG is from a 48-year-old man who had corrective surgery for Tetralogy of Fallot at the age of 8: Diagnosis Sinus rhythm Right bundle branch block Left anterior fascicular block Bifascicular block (RBBB and LAFB) Comment: In patients who …

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Case 87: A 59-Year-Old Woman in the CCU with Palpitation

Practice Level 5

Case 87: A 59-Year-Old Woman in the CCU with Palpitation History Diagnosis History This 59-year-old woman with known dilated cardiomyopathy and history of tachyarrhythmias has suddenly developed severe palpitation and dyspnea: Diagnosis Ventricular tachycardia, rate 128/min There is evidence of AV dissociation The atrial rhythm is atrial tachycardia, rate 180/min Comment: Further investigation of this patient …

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