interesting ecg,cxr,echo
TRANSCRIPT
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SPOTTERS(ECG,CXR,ECHO)
DR. MAHENDRACARDIOLOGY,JIPMER
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1.A 75 year old man with a history of COPD presents with fever and increased sputum production. An ECG is taken in the emergency department. What does it show?
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• Diagnosis: polymorphic atrial tachycardia• Ecg feature-• Heart rate > 100 bpm (usually 100-150 bpm; may be as high as 250 bpm).• Irregularly irregular rhythm with varying PP, PR and RR intervals.• At least 3 distinct P-wave morphologies in the same lead.• Isoelectric baseline between P-waves (i.e. no flutter waves).• Absence of a single dominant atrial pacemaker (i.e. not just sinus rhythm with frequent
PACs).• Some P waves may be nonconducted• others may be aberrantly conducted to the ventricles.
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2.68 yr old female with old MI, c/o palpitation ,giddiness ecg show??
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• Irregularly irregular rhythm • Rate approx. 200/min• Initially narrow complex change into wide complex tachycardia with changing
axis.• p/o• AF with aberrancy• Preexcited AF • VT
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3.Presented with palpitation
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After adenosine
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• Regular narrow complex tachycardia• Short RP• Rate 150/min, normal axis• Pseudo s and r present • Respond with adenosine • p/o AVNRT
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4.18 year old man signs up to join the army. He is fit and well. This is his ECG taken at his medical examination. Is it normal
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• ECG is characteristic of Brugada Syndrome (Type 1)•
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5.Diagnosis??
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• R on T phenomenon:• sinus rhythm with frequent PVCs in a pattern of ventricular bigeminy.• QT interval is markedly prolonged (at least 600ms), with each PVC falling on the
preceding T wave (= ‘R on T’ phenomenon).• ECG is extremely high risk for TdP
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6.diagnosis??
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• HYPOKALEMIA• Typical U wave seen• Camel hump sign• Prolonged repolarisation
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7.Diagnosis ??
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• Exercise stress test in a patient with CPVT. • Progressively worsening ventricular arrhythmias are observed during exercise.• Typical bidirectional VT develops after 1 minute of exercise • Arrhythmias rapidly recede during recovery.
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8.
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Atrial lead dislodgment to ventricle
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9.c/o recurrent palpitation diagnosis?
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Typical atrial flutter
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10.Pressure tracing interpretation ??
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11.6 yr old child with cyanosisleft side LV/RV tracing, rt side PA tracing
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• RV and Ao pressures are equal• PA pressures –Normal• Diagnosis
• VSD,PS physiology
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12.60 yr old male with cardiogenic shockxray taken after cardiac intervention
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28
- The end of the balloon should be just distal (1-2 cm) to the takeoff of the left subclavian artery
- Position should be confirmed by fluoroscopy or chest x-ray
iabp ballon positioning
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THANK YOU