Case 136: A 63-Year-Old Woman with a Prosthetic Aortic Valve History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History Six months ago, this 63-year-old man underwent replacement of his aortic valve for severe calcific aortic stenosis. He did well, and was symptom-free until one week ago when he started experiencing weakness, fatigue …
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Case 155: A 69-Year-Old Woman in the Emergency Department History Diagnosis ECG 2 ECG 2 Diagnosis History This 69-year-old woman was brought to the Emergency Department because of the recent onset of episodes of presyncope: Diagnosis Sinus rhythm with third degree AV block Escape wide-QRS rhythm , rate 45/min The narrow-QRS complex at the beginning …
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Case 159: A 75-Year-Old Woman who had a Recent CABG History Diagnosis ECG 2 ECG 2 Diagnosis ECG 3 ECG 3 Diagnosis History A 75-year-old woman is on the cardiac surgery ward two days after coronary artery bypass surgery: Diagnosis Atrial fibrillation with a junctional escape rhythm (rate 46/min). Consider the possibility of complete heart …
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Case 4: An 81-Year-Old Man in Pacemaker Clinic History Diagnosis History An 81-year-old man with a pacemaker is in the operating room for shoulder surgery. Pacemaker device was “reprogrammed” just prior to surgery: Diagnosis Sinus rhythm with VOO pacing (asynchronous mode with no ventricular sensing) – this mode was likely chosen to prevent inappropriate pacemaker inhibition …
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Case 5: A 68-Year-Old Man in the Emergency Room History Diagnosis History A 68-year-old man presents to the emergency room with palpitations. He has a previous history of hypertension and syncope with pacemaker implantation 3 years ago: Diagnosis Underlying atrial tachycardia (red arrows) – may be atrial flutter Native complexes conducted with left bundle branch …
Case 6: A 72-Year-Old Man in Pacemaker Clinic History Diagnosis History A 72-year-old man presents to pacemaker clinic for routine assessment. He complains of feeling weaker now than on his previous visit: Diagnosis Sinus rhythm with complete heart block VVI pacemaker with adequate sensing and capture Single isolated premature ventricular complex ECG ID: E781
Case 7: A 64-Year-Old Man in Pacemaker Clinic History Diagnosis History A 64-year-old man presents to the pacemaker clinic for routine assessment. He is asymptomatic: Diagnosis Dual chamber pacemaker (as evidenced by two pacemaker spikes on 3rd QRS complex) with intermittent atrial undersensing lead V1 is disconnected for first 2 seconds of recording Poor R-wave …
Case 18: A 46-Year-Old Man with Non-Ischemic Cardiomyopathy History Diagnosis ECG 2 ECG 2 Diagnosis History A 46-year-old man with a nonischemic dilated cardiomyopathy most likely secondary to a viral myocarditis from which he suffered 8 years earlier whom at the time of his myocarditis had a pacemaker implanted because of second degree AV block …
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Case 21: A 56 Year-OId Man in the Arrhythmia Clinic History Diagnosis History A 56-year-old man is in the arrhythmia clinic: Diagnosis Electronic ventricular pacemaker, VVI mode The underlying rhythm is sinus bradycardia, 50/min, with first degree AV block Paced ventricular rhythm, 66/min, with occasional fusion complexes and AV capture ECG ID: E623
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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