By David Adlam, John R. Hampton DM MA DPhil FRCP FFPM FESC, Jo Hampton
Wow, do not pass pass eyed but when it's a trend attractiveness ECG e-book you wish, this can be it, you'll have to learn the spouse ECG made effortless first - or purchase them jointly.
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Additional resources for 150 ECG Problems
ANSWER 25 3z ] The ECG shows: • • • • • m TO I M Sinus rhythm Normal axis Q waves in leads II, III, VF Normal QRS complexes in the anterior leads Marked ST segment elevation in leads V1-V6 Clinical interpretation The Q waves in leads III and VF suggest an old inferior infarction, while the elevated ST segments in leads V1-V6 indicate an acute anterior infarction. What to do The patient should be given pain relief, and in the absence of the usual contraindications should immediately be treated with aspirin and a thrombolytic agent.
Summary Atrial flutter with 2:1 conduction. See p. 68 Ij> [ See p. 160 ECG 28 This EGG was recorded from a 39-year-old woman who complained of a sudden onset of breathlessness. She had no previous history, and no chest pain. Examination reveals nothing other than a rapid heart rate. What is the diagnosis? ANSWER 28 The ECG shows: • • • • • • the sudden onset of breathlessness without pain suggests a pulmonary embolus, and here the VQ scan confirmed multiple small pulmonary infarcts. Sinus rhythm, rate 140/min Normal conduction Normal axis Normal QRS complexes Slightly depressed ST segments in leads V1-V4 Diphasic or inverted T waves in the inferior and all the chest leads Clinical interpretation The ECG shows a marked sinus tachycardia, with no change in the cardiac axis and normal QRS complexes.
The left axis may be due to left anterior hemiblock, although the QRS has a normal duration so the significance of the axis is uncertain. The persistent S wave in lead V6 suggests chronic lung disease. What to do Provided the patient is not in heart failure it is always a good idea to identify the cause of an arrhythmia before treating it. The combination of an atrial arrhythmia, jaundice and splenomegaly suggests alcoholism. The patient needs anticoagulants, but his international normalized ratio (INR) may already be high.
150 ECG Problems by David Adlam, John R. Hampton DM MA DPhil FRCP FFPM FESC, Jo Hampton