ecg quiz ecg session (jma) - thejma.lk fileinferior stemi 2. fast atrial fibrillation . question no:...
TRANSCRIPT
![Page 1: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/1.jpg)
ECG quiz ECG Session (JMA)
Dr K Ranjadayalan
Consultant Cardiologist
Newham
04/04/2018
![Page 2: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/2.jpg)
Question No: 1 37 year old male with left sided chest pain. What is the cause of his chest pain ?
![Page 3: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/3.jpg)
Acute Chest pain and ECG:
Clue will be on ST segment /T waves
• ACUTE MI - • ST elevation or ST depression
• T wave inversion (L1, L2, V3 – V6)
![Page 4: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/4.jpg)
Answer No: 1 Acute Pericarditis
“ Saddleback” ST segment elevation in most leads except aVR & V1
![Page 5: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/5.jpg)
Question No: 2 55 year old lady admitted with epigastric pain What is the cause of her epigastric pain ?
![Page 6: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/6.jpg)
Answer No: 2 Inferoposterior MI with Mobitz 1
![Page 7: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/7.jpg)
Question No : 3 2 causes for this patient’s Low BP ?
![Page 8: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/8.jpg)
Answer No :3 1. Inferior STEMI 2. Fast Atrial fibrillation
![Page 9: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/9.jpg)
Question No: 4 This patient developed heart burn while visiting his relative in the hospital What is the cause of his chest pain ?
![Page 10: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/10.jpg)
Answer No: 4 De Winter’s T waves –STEMI
- Is specific for left anterior descending artery (LAD) occlusion
![Page 11: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/11.jpg)
Question No:5 Describe the abnormality
![Page 12: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/12.jpg)
Question No: 6 65 yr old diabetic with LVF What is the likely cause of LVF
![Page 13: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/13.jpg)
Question No : 7 18 year old male with fever, cough, Right sided pleuritic chest pain What is the cause of his chest pain? What is the abnormality on his ECG ?
![Page 14: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/14.jpg)
Answer No : 7 Right sided pleurisy secondary to Pneumonia ECG shows Type 2 Brugada pattern
![Page 15: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/15.jpg)
Type 1 Brugada ECG
![Page 16: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/16.jpg)
Brugada syndrome
![Page 17: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/17.jpg)
Question No : 8 What is the diagnosis ?
Two investigations ?
![Page 18: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/18.jpg)
Question No : 8 NSTEACS Troponin and angiogram
![Page 19: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/19.jpg)
Question No : 9 60 year old male with recurrent chest pain relieved by morphine. Describe the ECG changes? What is the definitive treatment?
![Page 20: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/20.jpg)
Answer No :9 1.In a patient presenting with chest pain, the combination of- Widespread ST depression, ST elevation in aVR ≥ 1mm ST elevation in aVR ≥ V1 is strongly suggestive of left main stem(LMS) occlusion or severe multi-vessel disease. 2. Angiogram with a view to CABG/PCI
![Page 21: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/21.jpg)
Question No : 10 ECG recording (Lead 11 ) of a 75 year old patient with recurrent falls What are the two abnormalities on this rhythm strip ? Diagnosis and treatment ?
![Page 22: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/22.jpg)
Answer No : 10 Paroxysms of junctional tachycardia at around 140 /m Runs of tachycardia interspersed with long sinus pauses (up to 6 seconds) This is a classic example of Sick sinus with the “Tachy-brady” syndrome This patient needs a Pacemaker
![Page 23: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/23.jpg)
SA block
![Page 24: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/24.jpg)
Complete Heart Block
![Page 25: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/25.jpg)
Question No : 11 33 year old lady with chest pain and dizziness What is the cause of chest pain ?
![Page 26: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/26.jpg)
Answer No : 11 SVT (Re-entrant tachycardia -AVNRT)
![Page 27: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/27.jpg)
Question No : 12 65 year old lady with Syncope. What is the cause of her syncope?
![Page 28: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/28.jpg)
Atrial flutter -Typical
![Page 29: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/29.jpg)
Question No : 13 17 year old male with exertional Syncope. What is the cause of his syncope?
![Page 30: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/30.jpg)
Answer No : 13 VT with LBBB morphology – RV origin
![Page 31: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/31.jpg)
Arrhythmogenic right ventricular dysplasia (ARVD) is a rare type
of cardiomyopathy.
It occurs if the muscle tissue in the right ventricle dies and is
replaced with scar tissue.
This disrupts the heart's electrical signals and
causes arrhythmias.
Symptoms include palpitations and fainting after physical activity.
ARVD usually affects teens or young adults. It can cause
sudden cardiac arrest (SCA) in young athletes.
![Page 32: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/32.jpg)
Arrhythmogenic right ventricular dysplasia (ARVD)
![Page 33: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/33.jpg)
Question No : 14 32 year male with recurrent palpitations. What is the underlying cause of his palpitations ?
![Page 34: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/34.jpg)
Answer No : 14 WPW syndrome - 1930 – Louis Wolff, Sir John Parkinson, and Paul Dudley White
![Page 35: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/35.jpg)
Question No: 15 18 year old female with recurrent palpitations Strong F/H of PAF, and Sudden cardiac death. Describe the ECG? Diagnosis ?
![Page 36: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/36.jpg)
Answer No: 15 An extremely short QT interval (QTc -250ms), virtually absent ST segments (the end of the QRS complex merges with the start of the T wave) Very tall, narrow, symmetrically peaked T waves in the precordial leads. Diagnosis - Congenital short QT syndrome (SQTS) --associated with paroxysmal atrial and ventricular fibrillation, syncope and SCD
![Page 37: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/37.jpg)
SQTS - The most common initial presenting symptom is cardiac arrest or fast AF
![Page 38: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/38.jpg)
Question No: 16 30 year old with recurrent syncope. What is the cause of his syncope?
![Page 39: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/39.jpg)
Answer No: 16 Long QT Syndrome
![Page 40: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/40.jpg)
Question No 17 : 56 year old male, H/T with SOB
![Page 41: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/41.jpg)
Answer No 17 ; LVH causing Heart failure - HFPEF
![Page 42: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/42.jpg)
Patient with acute breathlessness Question No : 18 What are the two abnormalities on this ECG ?
![Page 43: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/43.jpg)
Patient with acute breathlessness Answer No : 18 1. RVH with strain 2. Right axis deviation
![Page 44: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/44.jpg)
Question No : 19 A 78 year old man is brought to your emergency department after being found on the floor of his home. His only past medical history is of congestive cardiac failure, and he is unable to remember his medications. Management ?
![Page 45: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/45.jpg)
Answer No : 19 Mobitz Type 2 block – 2:1 Check electrolytes, Troponin PPM
![Page 46: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/46.jpg)
Question No: 20 75 year old male on digoxin for AF, P/C Palpitations. What is the diagnosis?
![Page 47: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/47.jpg)
Digoxin toxicity
Both increased cardiac Automaticity and AV block: Atrial tachycardia Bidirectional VT AF with CHB and AJER
![Page 48: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/48.jpg)
Question No : 21 Bilateral leg swelling Cause ?
![Page 49: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/49.jpg)
Question No : 22 74 yr male.H/o collapse
![Page 50: ECG quiz ECG Session (JMA) - thejma.lk fileInferior STEMI 2. Fast Atrial fibrillation . Question No: 4 This patient developed heart burn while visiting his relative in the hospital](https://reader031.vdocument.in/reader031/viewer/2022020319/5d0199e888c993c93d8cebd8/html5/thumbnails/50.jpg)