Case 89: A 48-Year-Old Woman with Trisomy 21 History Diagnosis History This 48-year-old woman with Trisomy 21 has a known large ventricular septal defect and EIsenmenger syndrome. She is on continuous oxygen therapy and is very limited by dyspnea and fatigue on mild exertion: Diagnosis Sinus rhythm with one premature ventricular complex First degree AV …
Case 106: A 67-Year-Old Man with Severe Obstructive Lung Disease History Diagnosis History This 67-year-old man presents to the respirology clinic for routine follow-up. He has known COPD in the context of a 60 pack-year smoking history, and was recently started on home oxygen: Diagnosis Sinus rhythm Right bundle branch block plus right ventricular hypertrophy …
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Case 109: A 78-Year-Old Man in the Cardiac Clinic History Diagnosis History This 78-year-old man who had aorto-coronary bypass surgery ten years ago is in the cardiac clinic for a routine follow-up. He is stable and free of dyspnea or chest pain during moderate exertion. He denies any dizziness or syncope: Diagnosis Sinus rhythm with …
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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 115: A 71-Year-Old Man who Fainted History Diagnosis ECG 2 ECG 2 Diagnosis History This 71-year-old man with a known history of coronary artery disease and a previous myocardial infarction is seen in the emergency department following an episode of syncope at home. He collapsed and hit the back of his head. He reports …
Case 119: A 51-Year-Old Woman with Palpitations History Diagnosis History This 51 year old woman presents with palpitations, that she describes as a sensation of irregular pounding in her precordium.She has no other cardiac symptoms: Diagnosis Sinus rhythm with frequent premature atrial complexes with aberrant conduction The pattern of aberration varies (iRBBB, RBBB, LBBB). ECG …
Case 121: A 65-Year-Old Man in the Pacemaker Clinic History Diagnosis History This 65-year-old man presents to the pacemaker clinic for routine follow-up: Diagnosis Sinus rhythm with second degree AV block Mobitz II Escape paced QRS complexes (VVI pacemaker) Left axis deviation, Right bundle branch block This 65 year old patient has had diabetes for …
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Case 123: An 85-Year-Old Woman in the Pacemaker Clinic History Diagnosis History This 85-year-old woman had a ventricular pacemaker implanted 3 years ago after she developed third degree AV block during a stress test originally ordered due to dyspnea. She had no chest pain. The echocardiogram showed normal left ventricular function and mild mitral regurgitation. …
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Case 130: A 40-Year-Old Man with a Patent Ductus Arteriosus History Diagnosis History This 40-year-old man with a known patent ductus arteriosus presents with increasing dyspnea on exertion over the past five years: Diagnosis Sinus rhythm Right atrial enlargement Right bundle branch block plus right ventricular hypertrophy (RBBB and RVH) with repolarization abnormality This patient …
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Case 143: An 88-Year-Old Woman in the ICU History Diagnosis History This 88-year-old woman with a history of pulmonary tuberculosis, severe bullous emphysema, and pulmonary fibrosis was admitted to the intensive care unit with bronchopneumonia and acute respiratory insufficiency requiring intubation: Diagnosis Coarse atrial fibrillation with rapid ventricular response (136/min) Right bundle branch block Right …
