Right Ventricular Hypertrophy

Case 58: A 72-Year-Old Woman with Congestive Heart Failure

Practice Level 4

Case 58: A 72-Year-Old Woman with Congestive Heart Failure History Diagnosis History This 72-year-old woman with a history of rheumatic heart disease and a mechanical mitral valve is admitted to the cardiac ward for treatment of congestive heart failure: Diagnosis – Sinus rhythm, 88/min– Right axis deviation– Right ventricular hypertrophy with repolarization abnormality Comments: The echocardiogram …

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Case 75: A 25-Year-Old Woman in the ICU

Practice Level 4

Case 75: A 25-Year-Old Woman in the ICU History Diagnosis History This 25-year-old woman with chronic respiratory failure and hypoventilation secondary to kyphoscoliosis and restrictive lung disease is admitted to the Intensive Care Unit with pulmonary aspergillosis: Diagnosis Sinus tachycardia 110/min Biatrial enlargement Right axis deviation Right ventricular hypertrophy Diffuse T wave abnormality The presence …

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Case 76: A 53-Year-Old Man in Respiratory Distress

Practice Level 4

Case 76: A 53-Year-Old Man in Respiratory Distress History Diagnosis History This 53-year-old man with a history of heavy smoking and longstanding obstructive lung disease has been admitted to the medical ICU in severe respiratory distress with reduced air entry and diffuse wheezes bilaterally: Diagnosis Sinus rhythm, 98/min. Right atrial enlargement RBBB and RVH (Right …

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Case 101: A 68-Year-Old Man in the Medical ICU

Practice Level 4

Case 101: A 68-Year-Old Man in the Medical ICU History Diagnosis History This 68-year-old man with severe obstructive lung disease and pulmonary hypertension is admitted to the medical intensive care unit with extensive pneumonia: Diagnosis Multifocal atrial tachycardia, rate 140/min, with occasional aberrantly conducted QRS complexes (right bundle branch block pattern) Right ventricular hypertrophy The …

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Case 106: A 67-Year-Old Man with Severe Obstructive Lung Disease

Practice Level 4

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 130: A 40-Year-Old Man with a Patent Ductus Arteriosus

Practice Level 4

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

Practice Level 4

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 …

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Case 31: A 46-Year-Old Woman with Cyanosis and Clubbing

Practice Level 5

Case 31: A 46-Year-Old Woman with Cyanosis and Clubbing History Diagnosis History A 46-year-old woman known to have cyanotic congenital heart disease, is severely disabled: Diagnosis Sinus Rhythm First degree AV block Right atrial enlargement Incomplete right bundle branch block (iRBBB) Left anterior fascicular block Possible right ventricular hypertrophy Voltage criteria for left ventricular hypertrophy  …

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Case 34: A 71-Year-Old Woman in the Cardiac Surgical ICU

Practice Level 5

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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