Case 9: A 56-Year-Old Man Complaining of Fatigue History Diagnosis History This 56-year-old man reports that he had been well prior to one week ago, when he had an episode of syncope that lasted 15-20 seconds. Since then he reports fatigue and dyspnea on moderate exertion: Diagnosis Sinus rhythm Complete heart block with junctional escape …
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Case 64: A 58-Year-Old Man in the Coronary Care Unit History Diagnosis History A 58-year-old man is admitted to the coronary care unit with severe central anterior chest pain of 4 hour duration. This ECG tracing is recorded 2 hours after his admission: Diagnosis Sinus rhythm, 90/min Complete heart block,with escape junctional rhythm, 47/min Acute …
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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 121: A 76-Year-Old Woman Who Fainted History Diagnosis History A 76-year-old woman had a 2 years history of episodes of atrial fibrillation with rapid ventricular response. She was on Digoxin and Atenolol. The following ECG is recorded in the emergency department, where she is brought by ambulance after she fainted at home: Diagnosis Marked …
Case 133: A 51-Year-Old Man Referred from the Pre-op Clinic History Diagnosis ECG 2 ECG 2 Diagnosis History A 51-year-old man was assessed prior to a cholecystectomy and found to have an arrhythmia. During the previous 6 months he had noted fatigue and mild dyspnea on walking hastily: Diagnosis Sinus rhythm with complete heart block …
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Case 148: A 79 Year-Old Woman in Hospital with Palpitations History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History A 79 year-old woman is admitted to hospital with palpitations. Because of a previous history of atrial fibrillation, she had been started on a combination of flecainide and bisoprolol. She presented to …
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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 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 40: A 50-Year-Old Man in the Cardiac Surgical Ward History Diagnosis ECG 2 ECG 2 Diagnosis History A 50-year-old man is in the cardiac surgical ward two days after bypass surgery: Diagnosis Sinus tachycardia, 115/min, with complete heart block Junctional escape rhythm, with incomplete right bundle branch block (iRBBB) pattern and nonspecific ST abnormality …
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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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