Case 50: A 66-Year-Old Man with Cerebral Vascular Accident History Diagnosis History A 66-year-old man is admitted with intra-cerebral haemorrhage: Diagnosis Accelerated junctional rhythm, 89/min Long QT/QTc = 468/569 msec Junctional arrhythmias and QT prolongation may occur in patients with diseases of the central nervous system. ECG ID: E443
Case 68: A 60-Year-Old Man with Frequent Chest Pain History Diagnosis History A 60-year-old man is admitted to the CCU with one week history of frequent episodes of anterior chest pain at rest and on mild exertion: Diagnosis Sinus rhythm with AV dissociation due to a competing accelerated junctional rhythm Ventricular rate 65/min One AV …
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Case 16: A 66-Year-Old Woman in the Cardiac Surgery Unit History Diagnosis ECG 2 ECG 2 Diagnosis History This 66-year-old woman is in the cardiac surgery unit, 2 hours after triple aorto-coronary bypass: Diagnosis Accelerated junctional rhythm – ventricular rate 71/min Septal infarction, age undetermined T wave abnormality, consider anterior ischemia ECG 2 The following …
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Case 27: A 61-Year-Old Man in the Cardiac Surgical ICU History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis ECG 4 ECG Diagnosis History This 61-year-old man underwent closure of a large primum atrial septal defect (2.5 cm in width and 2.9 cm in height) with a pericardial patch and repair of …
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Case 84: A 69-Year-Old Woman in the CCU History Diagnosis History A 69-year-old woman is admitted to the CCU with unstable angina: Diagnosis Accelerated junctional rhythm, 84/min Non-specific ST abnormality Comment: One can see retrograde P-waves which are the result of “backwards” activation over the AV node (the junction fires, and electrical activation goes back …
Case 85: A 66-Year-Old Woman in the Cardiac Surgery Unit History Diagnosis History A 66-year-old woman is postoperative day 4 from replacement of her aortic valve due to aortic stenosis: Diagnosis Accelerated junctional rhythm, 82/min Minimal criteria for left ventricular hypertrophy (S in V1 + R in V6 = 36 mm) ECG ID: E474
Case 110: A 76-Year-Old Woman on the Cardiac Ward History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History This 76 year old woman is admitted to the cardiac ward for treatment of congestive heart failure. Of note, her QRS pattern has been unchanged since the time of her last admission four months ago: …
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Case 120: A 63-Year-Old Man in the Cardiac Surgery ICU History Diagnosis History A 63-year-old man is in the cardiac surgery ICU after replacement of a myxomatous mitral valve with ruptured cordae tendineae: Diagnosis Sinus Rhythm with sinus arrhythmia and AV dissociation due to a competing accelerated junctional rhythm 2 capture complexes (the 5th and …
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Case 36: A 79-Year-Old Man with Infective Endocarditis History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History This 79-year-old man is admitted with infective endocarditis and a para-aortic abscess. He underwent aortic valve replacement and debridement of the abscess: Diagnosis Atrial Flutter Complete heart block with escape accelerated junctional rhythm (76/min} Poor …
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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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