Case 20: A 45-Year-Old Man in the Cardiac Unit History Diagnosis History A 45-year-old man in the cardiac unit has suddenly experienced rapid palpitation, dyspnea and weakness: Diagnosis Ventricular tachycardia, rate 142/min In favour of the diagnosis of ventricular tachycardia: The clinical presentation Regular wide-QRS tachycardia AV dissociation (regular sinus P waves, rate 84/min; regular …
Case 67: A 64-Year-Old Man with a Slow Heart Rate History Diagnosis History A 48-year-old man recovering in hospital after repair of a dissected thoraco-abdominal aortic aneurysm is having periods of marked bradycardia but no episodes of syncope: Diagnosis Marked sinus bradycardia (sinus rate 37/min) AV dissociation, with an escape junctional rhythm, one AV capture, …
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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 11: A 57-Year-Old Man in the Cardiac Surgical Unit History Diagnosis ECG 2 ECG 2 Diagnosis History This 57-year-old man with severe unstable angina was taken to the operating room for urgent revascularization. He had four aorto-coronary bypasses and an endarterectomy of the right coronary artery. This ECG was recorded 30 minutes after transfer …
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Case 12: A 49-Year-Old Man in the Surgical ICU History Diagnosis History A 49-year-old man is in the surgical ICU, 6 hours after aorto-coronary bypass: Diagnosis Ventricular tachycardia, 130/min Comment: In favour of ventricular tachycardia are the wide QRS rhythm (120 msec QRS duration) with evidence of AV dissociation. The right bundle branch with right inferior axis …
Case 23: A 69-Year-Old Woman in the Cardiac Clinic History Diagnosis History This 69-year-old woman is referred by her family doctor. For several years, she has had episodes of paroxysmal atrial fibrillation. Recently, she complains of severe fatigue and faintness: Diagnosis AV dissociation Marked ectopic atrial bradycardia (P waves with abnormal morphology and axis – …
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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 38: A 42-Year-Old Man with Fatigue and Weakness History Diagnosis ECG 2 ECG 2 Diagnosis History A 42-year-old man presents to the Emergency Department with severe weakness and presyncope. He reports that four months ago, he started to notice fatigue on mild exertion. Previous ECG and Holter monitoring had shown sinus bradycardia at rest, limited …
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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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