Cases and Examples

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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

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A 45 year old female presents at the first heart aid with chest complaints...
Case provided by Kees-Jan Royaards, MD
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Wide complex tachycardia: ventricular or supraventricular? ...
Case provided by Kees-Jan Royaards, MD
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Myocardial infarction or not? ...
Case provided by Kees-Jan Royaards, MD
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Conduction trouble ...
Case provided by Kees-Jan Royaards, MD
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Sinus rhythm or not? ...
Case provided by JSSG de Jong, MD
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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

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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
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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
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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

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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
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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
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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
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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
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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

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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
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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
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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
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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
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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
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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
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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

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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
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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
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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
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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
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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
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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
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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
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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
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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

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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
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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
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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
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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
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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
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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
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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
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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

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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
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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
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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
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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
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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
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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


Advanced Cases

For more advanced cases see: