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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
}}
|}
|}


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|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 44: 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
}}
}}
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|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
}}
}}
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|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
}}
}}
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|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
}}
}}
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|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=
}}
}}
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==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
}}
|}


==Rhythm Puzzles==
==Rhythm Puzzles by Prof. A.A.M. Wilde==
===2009===
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
|- valign="top"
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}}
}}
|}
|}
===2008===
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
|- valign="top"
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}}
}}
|}
|}
===2007===
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
|- valign="top"
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|}
|}


===2006===
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
|- valign="top"
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|}
|}


===2005===
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
|- valign="top"
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}}
}}
|}
|}
===2004===
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
{| width="100%"  cellspacing="10" style="font-size: 90%;padding: 3px;  "
|- valign="top"
|- valign="top"
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|File=DVA0003.jpg
|File=DVA0003.jpg
|Link=DV Case 3
|Link=DV Case 3
|Description='''DV Case 3'''<br/>This Holter registration shows pauses.
|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
|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
}}
}}


{{Box|
|- valign="top"
==Advanced Cases==
{{Smallcase|
For more advanced cases see:
|File=ICBA00009.jpg
*[[Rhythm Puzzles]] by Prof. A.A.M. Wilde, MD, PhD
|Link=ICBA10
*[[Case reports by W.G. De Voogt%2C MD%2C PhD]]
|Description='''Sinus irregularity'''<br/>SA exit block
*The ''[[De Voogt ECG Archive]]'' contains > 2000 categorized ECGs
|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
}}
}}


[[Category:Cases and Examples]]
|- 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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