Cases and Examples: Difference between revisions

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|Link=An Unexpected Narrow QRS Complex -1-
|Link=An Unexpected Narrow QRS Complex -1-
|Description=A 95-year-old woman presents with palpitations. She has no relevant medical history and the present complaint is several days old...
|Description='''An Unexpected Narrow QRS Complex'''<br/>A 95-year-old woman presents with palpitations. She has no relevant medical history and the present complaint is several days old...
|Contributor=A.A.M. Wilde
|Contributor=A.A.M. Wilde
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|Link=An Irregular Heart Beat
|Link=An Irregular Heart Beat
|Description=A 71-year-old female patient presents to your outpatients clinic with an irregular heart rhythm. The complaints started a few weeks ago and seem to worsen...
|Description='''An Irregular Heart Beat'''<br/>A 71-year-old female patient presents to your outpatients clinic with an irregular heart rhythm. The complaints started a few weeks ago and seem to worsen...
|Contributor=A.A.M. Wilde
|Contributor=A.A.M. Wilde
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|Link=Syncope in an Old Lady
|Link=Syncope in an Old Lady
|Description=An 83-old-female patient presents to your outpatient clinic with a history of syncope. It has occurred three times in the last few months and there were no specific triggers...
|Description='''Syncope in an Old Lady'''<br/>An 83-old-female patient presents to your outpatient clinic with a history of syncope. It has occurred three times in the last few months and there were no specific triggers...
|Contributor=A.A.M. Wilde
|Contributor=A.A.M. Wilde
}}
}}

Revision as of 18:17, 19 May 2010

Below you can find some common examples. ECGs can be magnified by clicking on the image....

Ischemia & Myocardial Infarction

An overview of the coronary arteries. LM = 'Left Main' = mainstem; LAD = 'Left Anterior Descending' artery; RCX = Ramus Circumflexus; RCA = 'Right Coronary Artery'.

Guess the culprit coronary artery that was occluded in these examples of myocardial infarctions

examples of myocardial infarctions

Arrhythmias Cases

Casus1 2.jpg
A 45 year old female presents at the first heart aid with chest complaints...
Case provided by Kees-Jan Royaards, MD
KJcasus3.jpg
Wide complex tachycardia: ventricular or supraventricular? ...
Case provided by Kees-Jan Royaards, MD
KJcasus9.jpg
Myocardial infarction or not? ...
Case provided by Kees-Jan Royaards, MD
Triblock.png
Conduction trouble ...
Case provided by Kees-Jan Royaards, MD
JJ00004.png
Sinus rhythm or not? ...
Case provided by JSSG de Jong, MD
ECG000006.jpg
A patient presented with a broad complex tachycardia...
Case provided by

Electrolyte Disorders

Miscellaneous

Click on the text below the ECG for the answers. Click on the ECG for enlargement of the ECG itself...

Rhythm Puzzles

2009

Puzzle2009 08.jpg
An Unexpected Narrow QRS Complex
A 95-year-old woman presents with palpitations. She has no relevant medical history and the present complaint is several days old...
Case provided by A.A.M. Wilde
Puzzle2009 04.jpg
An Irregular Heart Beat
A 71-year-old female patient presents to your outpatients clinic with an irregular heart rhythm. The complaints started a few weeks ago and seem to worsen...
Case provided by A.A.M. Wilde
Puzzle2009 02.jpg
Syncope in an Old Lady
An 83-old-female patient presents to your outpatient clinic with a history of syncope. It has occurred three times in the last few months and there were no specific triggers...
Case provided by A.A.M. Wilde

2008

Puzzle 2008 04 014 fig1a.png
A 57-year-old man collapsed after one hour of angina symptoms in the presence of the alarmed ambulance personnel. He had never had any complaints...
Case provided by N.J.W. Verouden, R.J. de Winter, A.A.M. Wilde
Puzzle 2008 01 062 fig1.jpg
A 44-year-old male presented with palpitations. His medical history was otherwise uneventful and the family history revealed pacemaker...
Case provided by A.A.M. Wilde, J. Hrudova, J.G.M. Tans
Puzzle 2008 03 01.jpg
A 73-year-old man presents with palpitations (irregular heartbeat). There is no medical history. Physical examination reveals no abnormalities...
Case provided by A.A.M. Wilde
Puzzle 2008 05 01.jpg
A 55-year-old male without cardiac history is complaining of an irregular heartbeat. Physical examination and an echo reveal no abnormalities...
Case provided by A.A.M. Wilde
Puzzle 2008 06 01.jpg
A 36-year-old male comes to your outpatient clinic because of his family history. His father died suddenly at age 43 and his brother died suddenly at age 39...
Case provided by A.A.M. Wilde

2007

Puzzle 2007 1 33 fig1.jpg
A 38-year-old male patient presents with palpitations. He is not suffering from syncope or dizziness and has no other complaints...
Case provided by A.A.M. Wilde
Puzzle 20075 2 072 fig1.jpg
A 75-year-old lady presented with palpitations. Her medical history reveals cardiac surgery with a mitral valve repair combined...
Case provided by A.A.M. Wilde, H.H.D. Idzerda
Puzzle 2007 03 114 fig1.jpg
A boy with a birth weight of 3.030 g was born by caesarean section at 33 weeks of gestation because of bradycardia and severe...
Case provided by A.A.M. Wilde, N.A. Blom
Puzzle 2005 4 157 fig1.jpg
An 86-year-old man presents in your outpatient clinic with stable angina pectoris (NYHA 2/4). There is no further medical history...
Case provided by A.A.M. Wilde
Puzzle 2007 5 198 fig1.jpg
A 14-year-old girl complained of palpitations that occurred numerous times a week. There were no special triggers and, usually...
Case provided by A.A.M. Wilde, M. Cuppen, J.L.R.M. Smeets
Puzzle 2007 6 231 fig1.jpg
A 43-year-old man came to the outpatient clinic for preventive cardiovascular (CV) screening. During the last five years he...
Case provided by N.M. Panhuyzen-Goedkoop, L.R.C. Dekker, A.A.M. Wilde
Puzzle 2007 12 426 fig1.jpg
A 47-year-old lady presents with an ‘abnormal ECG’. In her family three daughters suffer from a long-QT syndrome type 2...
Case provided by A.A.M. Wilde

2006

Puzzle 2005 12 466 fig1.jpg
A 63-year-old female was referred to our outpatient clinic with symptoms of palpitations. These had been occurring in paroxysms...
Case provided by T.A. Simmers, A.A.M. Wilde
Puzzle 2006 1 33 fig1.jpg
A 34-year old man comes to your office. He has read in a newspaper about the familial occurrence of sudden death. He suffered a...
Case provided by A.A.M. Wilde, H.L. Tan
Puzzle 2006 3 108 fig1.jpg
A 28-year-old male was referred because of an abnormal ECG. He was having occasional palpitations. His family history is unremarkable...
Case provided by A.A.M. Wilde, L.R.C. Dekker
Puzzle 2006 4 154 fig1.jpg
A 90-year-old lady presented with chest pain which had a sudden onset in the middle of the night. There were no other symptoms...
Case provided by A.A.M. Wilde
Puzzle 2005 5 189 fig1.jpg
A 65-year-old male presented with palpitations and dizziness of sudden onset, without any associated chest pain or other symptoms...
Case provided by A.A.M. Wilde
Puzzle 2006 08 268 fig1.jpg
A 54-year-old man presented with palpitations. He had no other symptoms. Physical examination revealed, with the exception of a...
Case provided by A.A.M. Wilde, R.H. Bakker
Puzzle 2006 9 315 fig1.jpg
A 63-year-old lady presented with episodic chest pain without specific triggers (in particular no relation with exercise)...
Case provided by A.A.M. Wilde, R.H.J. Peters
Puzzle 2006 11 393 fig1.jpg
An otherwise healthy 57-year-old lady presented with palpitations without dizziness. The symptoms had been present for a couple...
Case provided by A.A.M. Wilde, L.R.C. Dekker
Puzzle 2006 12 436 fig1.jpg
A 28-year-old, wheelchair bound, female patient with Friedreich’s ataxia presents with an irregular heartbeat...
Case provided by A.A.M. Wilde

2005

Puzzle 2005 1 23 fig1.jpg
A 61-year-old male was referred with symtoms of exertional dyspnoea and palpitations. He had suffered an anterior myocardial...
Case provided by T.A. Simmers
Puzzle 2005 2 67 fig1.jpg
A 64-year-old man had an inferior myocardial infarction ten years ago. Lately he has been having palpitations with occasional dizziness...
Case provided by A.A.M. Wilde, R.B.A. van den Brink
Puzzle 2005 4 156 fig1.jpg
An otherwise healthy 32-year-old male was referred with palpitations. Attacks had been occurring monthly for several years...
Case provided by A.A.M. Wilde, R.B.A. van den Brink
Puzzle 2005 5 195 fig1.jpg
An otherwise healthy 66-year-old male was referred with complaints of central chest pain. He was not on any medication...
Case provided by T.A. Simmers, A.A.M. Wilde
Puzzle 2005 6 244 fig1.jpg
A 20-year-old male is having palpitations. They occur without a specific trigger, although episodes are sometimes related to...
Case provided by A.A.M. Wilde, R.B.A. van den Brink
Puzzle 2005 8 285 fig1.jpg
An otherwise healthy 24-year-old man was referred to our hospital because of drug refractory spells of palpitations accompanied by dizziness...
Case provided by A.A.M. Wilde, R.B.A. van den Brink
Puzzle 2005 10 373 fig1.jpg
A 33-year-old lady visited the cardiologist because of the sudden death of her brother at age 35. He died while watching TV...
Case provided by A.A.M. Wilde, Y.M. Pinto
Puzzle 2005 11 428 fig1.jpg
A 46-year-old male was admitted to our emergency room with dyspnoea. His medical history included congestive heart failure with a left ventricular ejection
Case provided by T.A. Simmers, A.A.M. Wilde

2004

Puzzle 2004 2 73.jpg
A fainting lady with some extrasystoles
A 30-year-old woman presents with repeated syncope. Her symptoms started a few months ago without a particular trigger...
Case provided by A.A.M. Wilde and H. Tan
Puzzle 2004 4 178 fig1.jpg
Syncopated Rhythm
A 65-year-old woman was admitted because of recurrent syncope. Her complaints were difficult to interpret due to mental...
Case provided by L.R.C. Dekker, R. Tukkie
Puzzle 2007 4 157 fig1.jpg
An Irregular Rhythm at Older Age
An 86-year-old man presents in your outpatient clinic with stable angina pectoris (NYHA 2/4). There is no further medical history...
Case provided by A.A.M. Wilde
Puzzle 2004 6 302 fig1.jpg
I Think a Niece of Mine was Referred to a Neurologist
In the setting of family screening, an 84-year-old lady was invited for a cardiogenetic evaluation. Two of her grandchildren...
Case provided by A.A.M. Wilde, T.A. Simmers
Nhj 2004 8 355.jpg
Just One Collapse During Soccer
A 14-year-old boy died suddenly while playing soccer. He was in the middle of a sprint when he suddenly succumbed...
Case provided by A.A.M. Wilde, T.A. Simmers
Puzzle 2004 10 469 fig1.png
Tachycardia Terminated by Adenosine
A 27-year-old female was referred to the emergency room with rapid palpitations...
Case provided by I.C.D. Westendorp, G.S. de Ruiter, L.V.A. Boersma, E.F.D. Wever
Nhj 2004 11 510-1.jpg
Nightly Phenomena, Day Time Work?
In 2002, an a trial demand inhibited (AAI) pacemaker was implanted in a young male (born 1984) because of a primary arrhythmia disorder.
Case provided by R. Tukkie, R. Rienks, A.A.M. Wilde


Advanced Cases

For more advanced cases see: