One ECG Case Daily

CABG (Coronary Artery Bypass Graft)

Case:

A 58 year old man presents with palpitation, shortness of breath. This is his ECG. Present your findings.

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ECG taken from Dr. Tanoy Mazumder

Corrected QT interval (QTc)
The corrected QT interval (QTc) estimates the QT interval at a standard heart rate of 60 bpm.
This allows comparison of QT values over time at different heart rates and improves detection of patients at increased risk of arrhythmias
There are multiple formulas used to estimate QTc.
It is not clear which formula is the most useful:

Bazett formula: QTC = QT / √ RR
Fridericia formula: QTC = QT / RR 1/3
Framingham formula: QTC = QT + 0.154 (1 – RR)
Hodges formula: QTC = QT + 1.75 (heart rate – 60)

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Case:

A 62 year old man presents with dyspnea. This is his ECG. Present your findings.

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Case:

A 72 year old lady presents with collapse. This is her ECG. Present your findings. How would you proceed?

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Case:

It is early January and a middle-aged man is found lying in a park. He is surrounded by bottles of Buckfast and has a GCS of 9. An ECG is performed in the ambulance. What is going on?

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Case:

A fit and well 31 year old man presents for a routine insurance medical. This is his ECG. Present your findings and give the diagnosis.

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Case:

This ECG was recorded from an 80-year-old man during a routine preoperative assessment. What does it show? What are the implications for surgery?

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Case:

55 y female with palpitation and chest pain.
What does the ECG show?

A. Sinus rhythm with 1st degree AV block

B. Atrial fibrillation

C. Atrial flutter

D. Accelerated junctional

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Case:

This ECG was recorded from a 55-year-old man who was admitted to hospital as an emergency with severe central chest pain that had been present for about an hour. He was pale, cold and clammy; his blood pressure was 100/80, but there were no signs of heart failure. What does this ECG show?

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Case:

55 y female with history hypothyroidism presented with palpitation and lightheadedness.

What is the most likely diagnosis based on the ECG findings?

A. AVNRT (PSVT)

B. Atrial flutter

C. Atrial tachycardia

D. Atrial fibrillation

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Case:

A 40 year old with sudden, diffused and central chest pain 16 hour ago. Now he has no pain. This ECG was done when pain was subsided.

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Case:

A 35 year old with a history of lupus and recent URI presents for chest pain. They are sitting up in bed and wince with every breath. EKG is shown.

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Case:

23-year-old with no pmhx on OCPs presents for a leg cramp and feels short of breath with activity. EKG is shown.

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Case:

A 30-year-old woman, who had a baby 3 months previously, complains of breathlessness, and this is her ECG. What is the problem?

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Case:

A 25-year-old man, known to have an atrial septal defect, was admitted to hospital as an emergency because of palpitations. His heart rate was 170/min, his blood pressure was 140/80 and there were no signs of heart failure. What is the cardiac rhythm and what would you do?

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Case:

A 38 y male patient presented with chest pain and headache. Cardiac enzymes were normal and follow up ECGs were the same as the one posted.

What is your interpretation?

A. Wellens’s syndrome

B. Apical HCM

C. Raised ICP due to bleeding

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Case:

A 50-year-old man returned from holiday in Spain saying that while there he had had some bad indigestion, but was now perfectly well. This is his ECG: what does it show and what would you do?

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Case:

65 y/o female with palpitations.
What is your interpretation?

A. Ventricular tachycardia
B. AVNRT, Bifascicular block (RBBB+LAHB)
C. Atrial flutter, Bifascicular block
D. PAT, Bifascicular block
E. Antidromic AVRT

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Case:

60 y/o male with dizziness and chest pain.

What is the most likely diagnosis?
A. Wellen’s syndrome
B. Left ventricular hypertrophy due to chronic hypertension
C. Apical hypertrophic cardiomyopathy
D. Raised ICP due to ICH

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There are three main components to an ECG (electrocardiogram) : the P wave, which represents the depolarization of the atria; the QRS complex, which represents the depolarization of the ventricles; and the T wave, which represents the repolarization of the ventricles.

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Case:

This ECG was recorded from a 48-year-old man who had had severe central chest pain for 1 h. What does it show and what would you do?

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Case:
A 60y/o male patient with a history of syncope...

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What is axis in ECG?
•It's the average direction of spread of the depolarization wave through the ventricles or the major cardiac vector as seen from the front is called Cardiac Axis.

Hexaxial Reference System:
•Normal Axis = QRS axis between -30° and +90°
•Right Axis Deviation = QRS axis greater than +90°
•Extreme Axis Deviation = QRS axis between -90° and 180° (AKA “Northwest Axis”)
•Left Axis Deviation = QRS axis less than -30°.

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Case:

A 75-year-old woman who complained of attacks of dizziness. It shows one abnormality. What is its significance?

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Case:

28 y male with intermittent chest pain for several days.

What is your interpretation?

A. LVH, Pericarditis

B. LVH, inferolateral MI

C. LVH, benign early repolarization

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Case:
A 60y/o female with palpitation...

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