By David Adlam, John R. Hampton DM MA DPhil FRCP FFPM FESC, Jo Hampton
Wow, do not pass move eyed but when it's a trend acceptance ECG e-book you wish, this can be it, you'll have to learn the significant other ECG made effortless first - or purchase them jointly.
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Extra resources for 150 ECG Problems
This is her preoperative ECG. What does it show and what would you do? ANSWER 12 The ECG shows: • Second degree (2:1) heart block • Prolonged PR interval (440 ms) in the conducted beats • Ventricular rate about 40/min • Normal QRS complexes and T waves Clinical interpretation Although the slow ventricular response raises the possibility of complete heart block, the fact that the PR interval is constant (albeit prolonged) shows that this is actually second degree block. The non-conducted P waves are not easy to see, but the clue lies in the abnormally shaped T waves in the anterior leads.
160 l^jjcj^j A 50-year-old man is admitted to hospital as an emergency, having had chest pain characteristic of a myocardial infarction for 4 h. Apart from the features associated with pain there are no abnormal physical findings. What does this ECG show and what would you do? ANSWER 14 The ECG shows: • • • • Sinus rhythm Normal axis Small Q waves in lead III but not elsewhere Elevated ST segments in leads II, III, VF, with upright T waves • T wave inversion in lead VL • Suggestion of ST segment depression in leads V2-V3 Clinical interpretation A classic ECG of an acute inferior myocardial infarction, with lead VL indicating ischaemia.
E. risk of bleeding from any important site), the patient should be given aspirin and then a thrombolytic agent. Summary Acute inferior myocardial infarction. See p. 96 See p. 237 ECG 15 A 20-year-old student complains of palpitations. Attacks occur about once per year. They start suddenly, his heart feels very fast and regular, and he quickly feels breathless and faint. The attacks stop suddenly after a few minutes. There are no abnormalities on examination, and this is his ECG. What would you do?
150 ECG Problems by David Adlam, John R. Hampton DM MA DPhil FRCP FFPM FESC, Jo Hampton