Case 122: A 64-Year-Old Man Recovering from AAA Repair History Diagnosis History This 64-year-old man is in hospital, recovering from a repair of a thoraco-abdominal aortic aneurysm: Diagnosis Marked sinus bradycardia, 38/min AV dissociation due an junctional escape rhythm (ventricular rate 43/min) One AV capture. Non-specific T wave abnormality This is an example of AV …
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Case 126: A 62-Year-Old Woman in the Cardiac Surgery ICU History Diagnosis History A 62-year-old woman is in the cardiac surgery ICU, postoperative day one from a mitral valve repair and annuloplasty. She had been known to have severe symptomatic mitral regurgitation due to a prolapsed and flail valve, secondary to myxomatous degeneration. Following surgery, …
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Case 144: A 55-Year-Old Woman in the Neurosurgery ICU History Diagnosis History This 55-year-old woman had surgery two day ago for the removal of a left temporal lobe tumor. Postoperatively, her heart rate was noted to be slow: Diagnosis Marked sinus bradycardia (38/min) with sinus arrhythmia Escape junctional bradycardia with isorhythmic AV dissociation There is …
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Case 152: A 66-Year-Old Woman with Chest Pain History Diagnosis ECG 2 ECG 2 Diagnosis History This 66-year-old woman with a history of hypertension is brought to the emergency department four hours after the onset of severe retrosternal chest pain, associated with dyspnea, diaphoresis and nausea: Diagnosis Sinus rhythm with successive ectopic ventricular complexes (accelerated idioventricular …
Case 157: A 73-Year-Old Man who had a Recent CABG History Diagnosis History This 73-year-old man is postoperative day 3 from an uncomplicated coronary artery bypass surgery: Diagnosis AV dissociation (sinus rhythm with accelerated idioventricular rhythm), followed by sinus rhythm with normal AV conduction Non-specific ST-T abnormality In the first half of the tracing, there …
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Case 8: A 32-Year-Old Woman with Palpitations History Diagnosis ECG 2 ECG 2 Diagnosis History A 32-year-old woman with a long-standing history of palpitation varying from moderately rapid and regular to “a few thumps” in the precordium has the following ECG recorded during a typical episode of rapid palpitation: Diagnosis Ventricular tachycardia, 115/min. The QRS …
Case 9: A 59-Year-Old Man in the Cardiac Surgery Intensive Care Unit History Diagnosis ECG 2 ECG 2 Diagnosis History A 59-year-old man is in the cardiac surgery ICU 5 hours after replacement of his aortic valve because of aortic stenosis: Diagnosis Atrial fibrillation with AV dissociation – Accelerated idioventricular rhythm, rate 73/min Consider the …
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Case 34: A 71-Year-Old Woman in the Cardiac Surgical ICU History Diagnosis History A 71-year-old woman has the following ECG recorded 2 days after surgical closure of an atrial septal defect: Diagnosis Ectopic atrial bradycardia AV dissociation with an escaping junctional pacemaker and occasional AV capture with a long PR (320 msec) Atrial rate 45/min …
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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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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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