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[[Image:coronary_anatomy.png|thumb| An overview of the coronary arteries. LM = 'Left Main' = mainstem; LAD = 'Left Anterior Descending' artery; RCX = Ramus Circumflexus; RCA = 'Right Coronary Artery'.]]
[[Image:coronary_anatomy.png|thumb| 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
Guess the culprit coronary artery that was occluded in these examples of myocardial infarctions
{| class="wikitable"  
 
! colspan="2" |examples of myocardial infarctions
'''Examples of Myocardial Infarctions'''
|-
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|
|- valign="top"
*[[MI 1]]
{{Smallcase|
*[[MI 2]]
|File=Ami0001.jpg
*[[MI 3]]
|Link=MI 1
*[[MI 4]]
|Description='''MI 1'''<br/>Where is this myocardial infarction located?
*[[MI 5]]
|Contributor=
*[[MI 6]]
}}
*[[MI 7]]
{{Smallcase|
*[[MI 8]]
|File=Ami0002.jpg
*[[MI 10]]
|Link=MI 2
*[[MI 11]]
|Description='''MI 2'''<br/>Where is this myocardial infarction located?
*[[MI 12]]
|Contributor=
|
}}
*[[MI 13]]
{{Smallcase|
*[[MI 14]]
|File=Ami0003.jpg
*[[MI 15]]
|Link=MI 3
*[[MI 16]]
|Description='''MI 3'''<br/>Where is this myocardial infarction located?
*[[MI 17]]
|Contributor=
*[[MI 18]]
}}
*[[MI 19]]
|- valign="top"
*[[MI 20]]
{{Smallcase|
*[[MI 21]]
|File=Ami0004.jpg
*[[MI 22]]
|Link=MI 4
*[[MI 23]]
|Description='''MI 4'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
{{Smallcase|
|File=Ami0005.jpg
|Link=MI 5
|Description='''MI 5'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
{{Smallcase|
|File=Ami0006.jpg
|Link=MI 6
|Description='''MI 6'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
|- valign="top"
{{Smallcase|
|File=Ami0007.jpg
|Link=MI 7
|Description='''MI 7'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
{{Smallcase|
|File=Ami0008.jpg
|Link=MI 8
|Description='''MI 8'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
{{Smallcase|
|File=Ami0009.jpg
|Link=MI 9
|Description='''MI 9'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
|- valign="top"
{{Smallcase|
|File=Ami0010.jpg
|Link=MI 10
|Description='''MI 10'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
{{Smallcase|
|File=Ami0011.jpg
|Link=MI 11
|Description='''MI 11'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
{{Smallcase|
|File=Ami0012.jpg
|Link=MI 12
|Description='''MI 12'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
|- valign="top"
{{Smallcase|
|File=Ami0013.jpg
|Link=MI 13
|Description='''MI 13'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
{{Smallcase|
|File=Casus2_2.jpg
|Link=MI 14
|Description='''MI 14'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
{{Smallcase|
|File=AMI_anterior_LAD.jpg
|Link=MI 15
|Description='''MI 15'''<br/>Where is this myocardial infarction located?
|Contributor=
}}
|- valign="top"
{{Smallcase|
|File=KJcasus5.jpg
|Link=MI 16
|Description='''MI 16'''<br/>Where is this myocardial infarction located?
|Contributor=C.J. Royaards, MD
}}
{{Smallcase|
|File=KJcasus6.jpg
|Link=MI 17
|Description='''MI 17'''<br/>Where is this myocardial infarction located?
|Contributor=C.J. Royaards, MD
}}
{{Smallcase|
|File=KJcasus7.jpg
|Link=MI 18
|Description='''MI 18'''<br/>Where is this myocardial infarction located?
|Contributor=C.J. Royaards, MD
}}
|- valign="top"
{{Smallcase|
|File=KJcasus8.jpg
|Link=MI 19
|Description='''MI 19'''<br/>Where is this myocardial infarction located?
|Contributor=C.J. Royaards, MD
}}
{{Smallcase|
|File=KJcasus10.jpg
|Link=MI 20
|Description='''MI 20'''<br/>Where is this myocardial infarction located?
|Contributor=C.J. Royaards, MD
}}
{{Smallcase|
|File=KJcasus12.jpg
|Link=MI 21
|Description='''MI 21'''<br/>Where is this myocardial infarction located?
|Contributor=C.J. Royaards, MD
}}
|- valign="top"
{{Smallcase|
|File=KJcasus13.jpg
|Link=MI 22
|Description='''MI 22'''<br/>Where is this myocardial infarction located?
|Contributor=C.J. Royaards, MD
}}
{{Smallcase|
|File=KJcasus16.jpg
|Link=MI 23
|Description='''MI 23'''<br/>Where is this myocardial infarction located?
|Contributor=C.J. Royaards, MD
}}
|}
|}
<!--
==Arrhythmias==
[[File:Casus1_2.jpg|100px|link=Case 1|[[Case 1]]]]
[[File:KJcasus3.jpg|100px|link=Case 2|[[Case 2]]]]
[[File:KJcasus9.jpg|100px|link=Case 3|[[Case 3]]]]
[[File:Triblock.png|100px|link=Case 4|[[Case 4]]]]
[[File:JJ00004.png|100px|link=Case 5|[[Case 5]]]]
[[File:ECG000006.jpg|100px|link=Example 26|[[Example 26]]]]
-->


==Arrhythmias Cases==
==Arrhythmias Cases==
Line 48: Line 160:
|File=Casus1_2.jpg
|File=Casus1_2.jpg
|Link=Case 1
|Link=Case 1
|Description=A 45 year old female presents at the first heart aid with chest complaints...
|Description='''Case 1'''<br/>A 45 year old female presents at the first heart aid with chest complaints...
|Contributor=Kees-Jan Royaards, MD
|Contributor=Kees-Jan Royaards, MD
}}
}}
Line 54: Line 166:
|File=KJcasus3.jpg
|File=KJcasus3.jpg
|Link=Case 2
|Link=Case 2
|Description=Wide complex tachycardia: ventricular or supraventricular? ...  
|Description='''Case 2'''<br/>Wide complex tachycardia: ventricular or supraventricular? ...  
|Contributor=Kees-Jan Royaards, MD
|Contributor=Kees-Jan Royaards, MD
}}
}}
Line 60: Line 172:
|File=KJcasus9.jpg
|File=KJcasus9.jpg
|Link=Case 3
|Link=Case 3
|Description=Myocardial infarction or not? ...  
|Description='''Case 3'''<br/>Myocardial infarction or not? ...  
|Contributor=Kees-Jan Royaards, MD
|Contributor=Kees-Jan Royaards, MD
}}
}}
Line 67: Line 179:
|File=Triblock.png
|File=Triblock.png
|Link=Case 4
|Link=Case 4
|Description=Conduction trouble ...  
|Description='''Case 4'''<br/>Conduction trouble ...  
|Contributor=Kees-Jan Royaards, MD
|Contributor=Kees-Jan Royaards, MD
}}
}}
Line 73: Line 185:
|File=JJ00004.png
|File=JJ00004.png
|Link=Case 5
|Link=Case 5
|Description=Sinus rhythm or not? ...  
|Description='''Case 5'''<br/>Sinus rhythm or not? ...  
|Contributor=JSSG de Jong, MD
|Contributor=JSSG de Jong, MD
}}
}}
Line 79: Line 191:
|File=ECG000006.jpg
|File=ECG000006.jpg
|Link=Example 26
|Link=Example 26
|Description=A patient presented with a broad complex tachycardia...
|Description='''Example 26'''<br/>A patient presented with a broad complex tachycardia...
|Contributor=
|Contributor=
}}
}}
Line 85: Line 197:


==Electrolyte Disorders==
==Electrolyte Disorders==
*[[Case 100]]
{| width="67%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
*[[Case 101]]
|- valign="top"
{{Smallcase|
|File=KJcasu17-1.jpg
|Link=Case 100
|Description='''Case 100'''<br/>Try to interprete this ECG using the 7+2 step method Look at the consecutive ECGs in this patient.
|Contributor=C.J. Royaards, MD
}}
{{Smallcase|
|File=KJcasu18-3.jpg
|Link=Case 101
|Description='''Case 101'''<br/>Look at the consecutive ECGs in this patient. What electrolyte disturbance do you expect?
|Contributor=C.J. Royaards, MD
}}
|}
 
==Miscellaneous==
==Miscellaneous==
Click on the text below the ECG for the '''answers'''. Click on the ECG for '''enlargement of the ECG''' itself...
Click on the text below the ECG for the '''answers'''. Click on the ECG for '''enlargement of the ECG''' itself...


<gallery>
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
Image:RVDB1.jpg|[[Example 23]]
|- valign="top"
Image:DVA0011.jpg|[[Example 24]]
{{Smallcase|
Image:DVA0229.jpg|[[Example 25]]
|File=RVDB1.jpg
</gallery>
|Link=Example 23
|Description='''Example 23'''<br/>
|Contributor=
}}
{{Smallcase|
|File=DVA0011.jpg
|Link=Example 24
|Description='''Example 24'''<br/>Typical Brugada syndrome ST segments in right precordial ECG leads (on spot diagnosis) aka 'type-1 Brugada ECG' with 1st degree AV block and broad P-waves.
|Contributor=W.G. de Voogt, MD, PhD
}}
{{Smallcase|
|File=DVA0229.jpg
|Link=Example 25
|Description='''Example 25'''<br/>A regular small-QRS tachycardia at about 300bpm with normal looking QRS complexes is most likely an Atrial flutter with 1:1 conduction over the AV node.
|Contributor=W.G. de Voogt, MD, PhD
}}
|}


{{Box|
==Rhythm Puzzles by Prof. A.A.M. Wilde==
==Advanced Cases==
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
For more advanced cases see:
|- valign="top"
*[[Rhythm Puzzles]] by Prof. A.A.M. Wilde, MD, PhD
{{Smallcase|
*[[Case reports by W.G. De Voogt%2C MD%2C PhD]]
|File=Puzzle2009_08.jpg
*The ''[[De Voogt ECG Archive]]'' contains > 2000 categorized ECGs
|Link=An Unexpected Narrow QRS Complex -1-
|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
}}
{{Smallcase|
|File=Puzzle2009_04.jpg
|Link=An Irregular Heart Beat
|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
}}
{{Smallcase|
|File=Puzzle2009_02.jpg
|Link=Syncope in an Old Lady
|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
}}
|}
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
{{Smallcase|
|File=Puzzle_2008_04_014_fig1a.png
|Link=Wide QRS Complexes in the Setting of Acute Myocardial Infarction: Good News or Bad?
|Description='''Wide QRS Complexes in the Setting of Acute Myocardial Infarction: Good News or Bad?'''<br/>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...
|Contributor=N.J.W. Verouden, R.J. de Winter, A.A.M. Wilde
}}
}}
{{Smallcase|
|File=Puzzle_2008_01_062_fig1.jpg
|Link=Just an Ordinary Flutter?
|Description='''Just an Ordinary Flutter?'''<br/>A 44-year-old male presented with palpitations. His medical history was otherwise uneventful and the family history revealed pacemaker...
|Contributor=A.A.M. Wilde, J. Hrudova, J.G.M. Tans
}}
{{Smallcase|
|File=Puzzle_2008_03_01.jpg
|Link=Wide Complexes Intervening Regular Sinus Rhythm - 3
|Description='''Wide Complexes Intervening Regular Sinus Rhythm - 3'''<br/>A 73-year-old man presents with palpitations (irregular heartbeat). There is no medical history. Physical examination reveals no abnormalities...
|Contributor=A.A.M. Wilde
}}
|- valign="top"
{{Smallcase|
|File=Puzzle_2008_05_01.jpg
|Link=Wide Complexes Intervening Regular Sinus Rhythm - 4
|Description='''Wide Complexes Intervening Regular Sinus Rhythm - 4'''<br/>A 55-year-old male without cardiac history is complaining of an irregular heartbeat. Physical examination and an echo reveal no abnormalities...
|Contributor=A.A.M. Wilde
}}
{{Smallcase|
|File=Puzzle_2008_06_01.jpg
|Link=The ECG of a Cardiomyopathy - 2
|Description='''The ECG of a Cardiomyopathy - 2'''<br/>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...
|Contributor=A.A.M. Wilde
}}
|}
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
{{Smallcase|
|File=Puzzle_2007_1_33_fig1.jpg
|Link=Wide Complexes Intervening Regular Sinus Rhythm - 2
|Description='''Wide Complexes Intervening Regular Sinus Rhythm - 2'''<br/>A 38-year-old male patient presents with palpitations. He is not suffering from syncope or dizziness and has no other complaints...
|Contributor=A.A.M. Wilde
}}
{{Smallcase|
|File=Puzzle_20075_2_072_fig1.jpg
|Link=Palpitations after a MAZE Procedure
|Description='''Palpitations after a MAZE Procedure'''<br/>A 75-year-old lady presented with palpitations. Her medical history reveals cardiac surgery with a mitral valve repair combined...
|Contributor=A.A.M. Wilde, H.H.D. Idzerda
}}
{{Smallcase|
|File=Puzzle_2007_03_114_fig1.jpg
|Link=Abnormal Repolarization, Spot Diagnosis?
|Description='''Abnormal Repolarization, Spot Diagnosis?'''<br/>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...
|Contributor=A.A.M. Wilde, N.A. Blom
}}
|- valign="top"
{{Smallcase|
|File=Puzzle_2005_4_157_fig1.jpg
|Link=An Irregular Rhythm at Older Age
|Description='''An Irregular Rhythm at Older Age'''<br/>An 86-year-old man presents in your outpatient clinic with stable angina pectoris (NYHA 2/4). There is no further medical history...
|Contributor=A.A.M. Wilde
}}
{{Smallcase|
|File=Puzzle_2007_5_198_fig1.jpg
|Link=Palpitations all the Time
|Description='''Palpitations all the Time'''<br/>A 14-year-old girl complained of palpitations that occurred numerous times a week. There were no special triggers and, usually...
|Contributor=A.A.M. Wilde, M. Cuppen, J.L.R.M. Smeets
}}
{{Smallcase|
|File=Puzzle_2007_6_231_fig1.jpg
|Link=Five Years of Palpitations
|Description='''Five Years of Palpitations'''<br/>A 43-year-old man came to the outpatient clinic for preventive cardiovascular (CV) screening. During the last five years he...
|Contributor=N.M. Panhuyzen-Goedkoop, L.R.C. Dekker, A.A.M. Wilde
}}
|- valign="top"
{{Smallcase|
|File=Puzzle_2007_12_426_fig1.jpg
|Link=An Abnormal ECG?
|Description='''An Abnormal ECG?'''<br/>A 47-year-old lady presents with an ‘abnormal ECG’. In her family three daughters suffer from a long-QT syndrome type 2...
|Contributor=A.A.M. Wilde
}}
|}


[[Category:Cases and Examples]]
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
{{Smallcase|
|File=Puzzle_2005_12_466_fig1.jpg
|Link=Right You Are
|Description='''Right You Are'''<br/>A 63-year-old female was referred to our outpatient clinic with symptoms of palpitations. These had been occurring in paroxysms...
|Contributor=T.A. Simmers, A.A.M. Wilde
}}
{{Smallcase|
|File=Puzzle_2006_1_33_fig1.jpg
|Link=Should I be Worried?
|Description='''Should I be Worried?'''<br/>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...
|Contributor=A.A.M. Wilde, H.L. Tan
}}
{{Smallcase|
|File=Puzzle_2006_3_108_fig1.jpg
|Link=A Pre-excited Wide QRS Complex: is That all There is?
|Description='''A Pre-excited Wide QRS Complex: is That all There is?'''<br/>A 28-year-old male was referred because of an abnormal ECG. He was having occasional palpitations. His family history is unremarkable...
|Contributor=A.A.M. Wilde, L.R.C. Dekker
}}
|- valign="top"
{{Smallcase|
|File=Puzzle_2006_4_154_fig1.jpg
|Link=An Old Lady with Chest Pain
|Description='''An Old Lady with Chest Pain'''<br/>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...
|Contributor=A.A.M. Wilde
}}
{{Smallcase|
|File=Puzzle_2005_5_189_fig1.jpg
|Link=Palpitations and Dizziness in a 65-Year-Old-Man
|Description='''Palpitations and Dizziness in a 65-Year-Old-Man'''<br/>A 65-year-old male presented with palpitations and dizziness of sudden onset, without any associated chest pain or other symptoms...
|Contributor=A.A.M. Wilde
}}
{{Smallcase|
|File=Puzzle_2006_08_268_fig1.jpg
|Link=A Narrow QRS Complex Tachycardia Sensitive to Isoptin
|Description='''A Narrow QRS Complex Tachycardia Sensitive to Isoptin'''<br/>A 54-year-old man presented with palpitations. He had no other symptoms. Physical examination revealed, with the exception of a...
|Contributor=A.A.M. Wilde, R.H. Bakker
}}
|- valign="top"
{{Smallcase|
|File=Puzzle_2006_9_315_fig1.jpg
|Link=And What About the ECG?
|Description='''And What About the ECG?'''<br/>A 63-year-old lady presented with episodic chest pain without specific triggers (in particular no relation with exercise)...
|Contributor=A.A.M. Wilde, R.H.J. Peters
}}
{{Smallcase|
|File=Puzzle_2006_11_393_fig1.jpg
|Link=Palpitations Again, Have a Closer Look
|Description='''Palpitations Again, Have a Closer Look'''<br/>An otherwise healthy 57-year-old lady presented with palpitations without dizziness. The symptoms had been present for a couple...
|Contributor=A.A.M. Wilde, L.R.C. Dekker
}}
{{Smallcase|
|File=Puzzle_2006_12_436_fig1.jpg
|Link=Wide Complexes Intervening Regular Sinus Rhythm
|Description='''Wide Complexes Intervening Regular Sinus Rhythm'''<br/>A 28-year-old, wheelchair bound, female patient with Friedreich’s ataxia presents with an irregular heartbeat...
|Contributor=A.A.M. Wilde
}}
|}
 
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
{{Smallcase|
|File=Puzzle_2005_1_23_fig1.jpg
|Link=ECG puzzle: Appearances Can be Deceiving
|Description='''ECG puzzle: Appearances Can be Deceiving'''<br/>A 61-year-old male was referred with symtoms of exertional dyspnoea and palpitations. He had suffered an anterior myocardial...
|Contributor=T.A. Simmers
}}
{{Smallcase|
|File=Puzzle_2005_2_67_fig1.jpg
|Link=Where Do the Extras Come From?
|Description='''Where Do the Extras Come From?'''<br/>A 64-year-old man had an inferior myocardial infarction ten years ago. Lately he has been having palpitations with occasional dizziness...
|Contributor=A.A.M. Wilde, R.B.A. van den Brink
}}
{{Smallcase|
|File=Puzzle_2005_4_156_fig1.jpg
|Link='The Turtle and the Hare'
|Description='''The Turtle and the Hare'''<br/>An otherwise healthy 32-year-old male was referred with palpitations. Attacks had been occurring monthly for several years...
|Contributor=A.A.M. Wilde, R.B.A. van den Brink
}}
|- valign="top"
{{Smallcase|
|File=Puzzle_2005_5_195_fig1.jpg
|Link=Now You See it, Now You Don't
|Description='''Now You See it, Now You Don't'''<br/>An otherwise healthy 66-year-old male was referred with complaints of central chest pain. He was not on any medication...
|Contributor=T.A. Simmers, A.A.M. Wilde
}}
{{Smallcase|
|File=Puzzle_2005_6_244_fig1.jpg
|Link=It's Not What You Think it Is
|Description='''It's Not What You Think it Is'''<br/>A 20-year-old male is having palpitations. They occur without a specific trigger, although episodes are sometimes related to...
|Contributor=A.A.M. Wilde, R.B.A. van den Brink
}}
{{Smallcase|
|File=Puzzle_2005_8_285_fig1.jpg
|Link=One is Enough, Two is Too Many
|Description='''One is Enough, Two is Too Many'''<br/>An otherwise healthy 24-year-old man was referred to our hospital because of drug refractory spells of palpitations accompanied by dizziness...
|Contributor=A.A.M. Wilde, R.B.A. van den Brink
}}
|- valign="top"
{{Smallcase|
|File=Puzzle_2005_10_373_fig1.jpg
|Link=The ECG of a (Cardio)myopathy?
|Description='''The ECG of a (Cardio)myopathy?'''<br/>A 33-year-old lady visited the cardiologist because of the sudden death of her brother at age 35. He died while watching TV...
|Contributor=A.A.M. Wilde, Y.M. Pinto
}}
{{Smallcase|
|File=Puzzle_2005_11_428_fig1.jpg
|Link=The Ions Have It
|Description='''The Ions Have It'''<br/>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
|Contributor=T.A. Simmers, A.A.M. Wilde
}}
|}
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
{{Smallcase|
|File=Puzzle_2004_2_73.jpg
|Link=A fainting lady with some extrasystoles
|Description='''A fainting lady with some extrasystoles'''<br/>A 30-year-old woman presents with repeated syncope. Her symptoms started a few months ago without a particular trigger...
|Contributor=A.A.M. Wilde and H. Tan
}}
{{Smallcase|
|File=Puzzle_2004_4_178_fig1.jpg
|Link=Syncopated Rhythm
|Description='''Syncopated Rhythm'''<br/>A 65-year-old woman was admitted because of recurrent syncope. Her complaints were difficult to interpret due to mental...
|Contributor=L.R.C. Dekker, R. Tukkie
}}
{{Smallcase|
|File=Puzzle_2007_4_157_fig1.jpg
|Link=Rhythm Puzzle: An Irregular Rhythm at Older Age
|Description='''An Irregular Rhythm at Older Age'''<br/>An 86-year-old man presents in your outpatient clinic with stable angina pectoris (NYHA 2/4). There is no further medical history...
|Contributor=A.A.M. Wilde
}}
|- valign="top"
{{Smallcase|
|File=Puzzle_2004_6_302_fig1.jpg
|Link=I Think a Niece of Mine was Referred to a Neurologist
|Description='''I Think a Niece of Mine was Referred to a Neurologist'''<br/>In the setting of family screening, an 84-year-old lady was invited for a cardiogenetic evaluation. Two of her grandchildren...
|Contributor=A.A.M. Wilde, T.A. Simmers
}}
{{Smallcase|
|File=Nhj_2004_8_355.jpg
|Link=Just One Collapse During Soccer
|Description='''Just One Collapse During Soccer'''<br/>A 14-year-old boy died suddenly while playing soccer. He was in the middle of a sprint when he suddenly succumbed...
|Contributor=A.A.M. Wilde, T.A. Simmers
}}
{{Smallcase|
|File=Puzzle_2004_10_469_fig1.png
|Link=Tachycardia Terminated by Adenosine
|Description='''Tachycardia Terminated by Adenosine'''<br/>A 27-year-old female was referred to the emergency room with rapid palpitations...
|Contributor=I.C.D. Westendorp, G.S. de Ruiter, L.V.A. Boersma, E.F.D. Wever
}}
|- valign="top"
{{Smallcase|
|File=Nhj_2004_11_510-1.jpg
|Link=Nightly Phenomena, Day Time Work?
|Desctitle=Nightly Phenomena, Day Time Work?
|Description=In 2002, an a trial demand inhibited (AAI) pacemaker was implanted in a young male (born 1984) because of a primary arrhythmia disorder.
|Contributor=R. Tukkie, R. Rienks, A.A.M. Wilde
}}
|}
 
==Case reports by W.G. De Voogt, MD, PhD==
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
{{Smallcase|
|File=DVA0003.jpg
|Link=DV Case 3
|Description='''Case: what kind of block?'''<br/>This Holter registration shows pauses.
|Contributor=W.G. De Voogt, MD, PhD
}}
{{Smallcase|
|File=DVA0004.jpg
|Link=DV Case 4
|Description='''Case: a slow heart rate'''<br/>This ECG shows pauses in the heart rhythm.
|Contributor=W.G. De Voogt, MD, PhD
}}
{{Smallcase|
|File=DVA0005.jpg
|Link=DV Case 5
|Description='''Case: a pause in the heart rate'''<br/>This tracing shows a pause in the heart rhythm.
|Contributor=W.G. De Voogt, MD, PhD
}}
|- valign="top"
{{Smallcase|
|File=DVA0006.jpg
|Link=DV Case 6
|Description='''Case: fever with arrhythmias'''<br/>This is a tracing of a 52 year old male, with viral infection and high fever (40° C), who was admitted to the...
|Contributor=W.G. De Voogt, MD, PhD
}}
|}
 
==Case reports from the ICBA==
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
{{Smallcase|
|File=ICBA00001.jpg
|Link=ICBA1
|Description='''Fusion beats'''<br/>Sinus bradycardia, Second degree 2:1 AV block with LBBB in the conducted beats and junctional escape beats with RBBB morphology and fusion beats that mimic normal intraventricular conduction.
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00002.jpg
|Link=ICBA2
|Description='''LBBB and RBBB'''<br/>Sinus rythm, 2:1 AV block with RBBB in the left part of the EKG and after a 1:1 conducted beat with LBBB the 2:1 AV block continues with LBBB. So it is a bilateral branch block.
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00003.jpg
|Link=ICBA3
|Description='''Fusion beats'''<br/>Sinus rythm, high degree AV block, conducted beats with RBBB and ventricular escape beats with LBBB image. Some fusion beats mimic no intraventricular disturbance confundinc as normal conducted beats.
|Contributor=Dr. Alberto Giniger
}}
 
|- valign="top"
{{Smallcase|
|File=ICBA00004.jpg
|Link=ICBA4
|Description='''Escape beats'''<br/>Sinus rythm, high degree AV block with unional escape beats and capture beats with RBBB.
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00008.jpg
|Link=ICBA5
|Description='''Orthodromic tachycardia in WPW'''<br/>AV orthodromic tachycardia (WPW syndrome).
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00010.jpg
|Link=ICBA6
|Description='''Ventricular tachcyardia'''<br/>Ventricular tachycardia or idioventricular rythm during sinus tachycardia with fusion beats.
|Contributor=Dr. Alberto Giniger
}}
 
|- valign="top"
{{Smallcase|
|File=ICBA00005.jpg
|Link=ICBA7
|Description='''Escape rhythm with RBBB pattern'''<br/>
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00006.jpg
|Link=ICBA8
|Description='''Escape rhythm with LBBB pattern'''<br/>Escape rhythm with left bundle branch block pattern and likely retrograde conducted P waves.
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00007.jpg
|Link=ICBA9
|Description='''Intermittent pre-exitation'''<br/>Intermittent pre-exitation
|Contributor=Dr. Alberto Giniger
}}
 
|- valign="top"
{{Smallcase|
|File=ICBA00009.jpg
|Link=ICBA10
|Description='''Sinus irregularity'''<br/>SA exit block
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00011.jpg
|Link=ICBA11
|Description='''Complete AV block and left ventricle escape'''<br/>Complete AV block and left ventricle escape.
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00012.jpg
|Link=ICBA12
|Description='''Idionodal escape rythm and ventricular capture by AV nodal reentry'''<br/>Idionodal escape rythm and ventricular capture by AV nodal reentry...
|Contributor=Dr. Alberto Giniger
}}
 
|- valign="top"
{{Smallcase|
|File=ICBA00013.jpg
|Link=ICBA13
|Description='''Idioventricular rythm with 1:1 V-A conduction'''<br/>Idioventricular rythm with 1:1 V-A conduction.
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00014.jpg
|Link=ICBA14
|Description='''Mobitz II AV block with LBBB in the conducted beats'''<br/>Mobitz II AV block with LBBB in the conducted beats.
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00015.jpg
|Link=ICBA15
|Description='''Idioventricular accelerated rythm with fusion beats'''<br/>Idioventricular accelerated rythm with fusion beats.
|Contributor=Dr. Alberto Giniger
}}
 
|- valign="top"
{{Smallcase|
|File=ICBA00016.jpg
|Link=ICBA16
|Description='''AV nodal reentry tachycardia'''<br/>AV nodal reentry tachycardia. Also look at the below ladder diagram.
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00017.jpg
|Link=ICBA17
|Description='''3:1 AV block with idionodal escape (the third P wave is inside the QRS)'''<br/>AV block with idionodal escape (the third P wave is inside the QRS).
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00018.jpg
|Link=ICBA18
|Description='''Sinus bradicardia and isorythmic nodal escapes'''<br/>Sinus bradicardia and isorythmic nodal escapes.
|Contributor=Dr. Alberto Giniger
}}
|- valign="top"
{{Smallcase|
|File=ICBA00019.jpg
|Link=ICBA19
|Description='''Coarse atrial fibrillation mimic atrial flutter'''<br/>Coarse atrial fibrillation mimic atrial flutter.
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00020.jpg
|Link=ICBA20
|Description='''Long QT and VPB secondary to sotalol administration'''<br/>Long QT and VPB secondary to sotalol administration
|Contributor=Dr. Alberto Giniger
}}
{{Smallcase|
|File=ICBA00023.jpg
|Link=ICBA21
|Description='''Intermittent WPW'''<br/>Intermittent WPW
|Contributor=Dr. Alberto Giniger
}}
 
|}
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