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Case 32: A 79-Year-Old Man with Ischemic Cardiomyopathy

Practice Level 2

Case 32: A 79-Year-Old Man with Ischemic Cardiomyopathy History Diagnosis ECG 2 ECG 2 Diagnosis History A 79-year-old man with known ischemic cardiomyopathy has sudden onset of palpitation and severe dyspnea: Diagnosis Ventricular tachycardia, 170/min Strongly favouring the diagnosis of ventricular tachycardia: The clinical history (sudden onset of wide QRS tachycardia and severe symptoms in …

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Case 34: A 54-Year-Old Man in the Emergency Department

Practice Level 2

Case 34: A 54-Year-Old Man in the Emergency Department History Diagnosis ECG 2 ECG 2 Diagnosis History A 54-year-old man with type 2 diabetes, hypertension and hypercholesterolemia is brought by ambulance to the Emergency Department 1 hour after the onset of severe retrosternal pain: Diagnosis Sinus rhythm with first degree AV block Acute inferior myocardial …

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Case 36: A 75-Year-Old Woman with Intermittent Palpitations

Practice Level 2

Case 36: A 75-Year-Old Woman with Intermittent Palpitations History Diagnosis ECG 2 ECG 2 Diagnosis History A 75-year-old woman with a 10-year history of well-treated hypertension is referred for cardiac assessment for intermittent palpitation, that she describes as the sensation of her heart “beating strong and fast”: Diagnosis Atrial flutter with 2 to 1 AV …

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Case 37: An 81-Year-Old Man with a History of Myocardial Infarction

Practice Level 2

Case 37: An 81-Year-Old Man with a History of Myocardial Infarction History Diagnosis History An 81-year-old man suffered from a myocardial infarction 5 years ago. He has been stable and free of angina, but recently he has been concerned about palpitation: Diagnosis Sinus rhythm, 82/min with premature atrial complexes Left axis deviation (QRS positive in …

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Case 38: A 74-Year-Old Woman with Shortness of Breath

Practice Level 2

Case 38: A 74-Year-Old Woman with Shortness of Breath History Diagnosis History A 74-year-old woman is presenting to her family physician’s office with complaints of shortness of breath on climbing stairs in her home. Diagnosis Atrial fibrillation with rapid ventricular response (102/min) Left ventricular hypertrophy (LVH) with QRS widening and repolarization abnormality This patient had …

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Case 40: A 50-Year-Old Woman with a Prosthetic Cardiac Valve

Practice Level 2

Case 40: A 50-Year-Old Woman with a Prosthetic Cardiac Valve History Diagnosis History A 50-year-old woman is presenting one month after replacement of her aortic valve with a mechanical prosthesis because of severe aortic stenosis: Diagnosis Atrial flutter with variable AV conduction Ventricular rate 107/min Comment: The ECG shows no evidence of LVH in this …

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