Seventy-nine year old woman who five days prior to this electrocardiogram experienced acute onset chest discomfort
Clinical History 37
Seventy-nine year old woman who five days prior to this electrocardiogram experienced acute onset chest discomfort and an electrocardiogram consistent with an acute inferior myocardial infarction. Following her myocardial infarction convalescence a cardiac catheterization demonstrated severe three-vessel coronary artery disease. This electrocardiogram was obtained prior to anticipated coronary artery bypass graft surgery. Left ventriculography at the time of her cardiac catheterization demonstrated proximal and mid inferior wall akinesis. Her medications included metoprolol, intravenous heparin, intravenous nitroglycerin andtemazepam.
Comment on this ECG ?
Seventy-nine year old woman who five days prior to this electrocardiogram experienced acute onset chest discomfort and an electrocardiogram consistent with an acute inferior myocardial infarction. Following her myocardial infarction convalescence a cardiac catheterization demonstrated severe three-vessel coronary artery disease. This electrocardiogram was obtained prior to anticipated coronary artery bypass graft surgery. Left ventriculography at the time of her cardiac catheterization demonstrated proximal and mid inferior wall akinesis. Her medications included metoprolol, intravenous heparin, intravenous nitroglycerin andtemazepam.
Seventy-two year old woman with recent onset angina pectoris
Clinical History 74
Sixty-four year old gentleman who presented to the emergency room with a two week history of bilateral arm discomfort and numbness. This escalated immediately before presentation and the accompanying electrocardiogram was obtained. An urgent cardiac catheterization demonstrated a 90% proximal left anterior descending coronary artery stenosis, an 80% left circumflex coronary artery stenosis and an 80% right coronary artery stenosis. Left ventriculography demonstrated antero-apical and infero-apical myocardial infarctions and overall moderate left ventricular systolic dysfunction. The patient was treated medically without further cardiac intervention.
Comment on this ECG ?
Sixty-four year old gentleman who presented to the emergency room with a two week history of bilateral arm discomfort and numbness. This escalated immediately before presentation and the accompanying electrocardiogram was obtained. An urgent cardiac catheterization demonstrated a 90% proximal left anterior descending coronary artery stenosis, an 80% left circumflex coronary artery stenosis and an 80% right coronary artery stenosis. Left ventriculography demonstrated antero-apical and infero-apical myocardial infarctions and overall moderate left ventricular systolic dysfunction. The patient was treated medically without further cardiac intervention.
Clinical History Seventy-two year old woman who presented to the hospital after three hours of severe epigastric pressure
Clinical History 34
Seventy-two year old woman who presented to the hospital after three hours of severe epigastric pressure with associated vomiting, nausea and profuse diaphoresis. Serial cardiac enzymes documented acute myocardial injury. Medications at the time of this electrocardiogram included phenytoin, glyburide, ranitidine, lisinopril. intravenous heparin and intravenous nitroglycerin.
Comment on this ECG ?
Seventy-two year old woman who presented to the hospital after three hours of severe epigastric pressure with associated vomiting, nausea and profuse diaphoresis. Serial cardiac enzymes documented acute myocardial injury. Medications at the time of this electrocardiogram included phenytoin, glyburide, ranitidine, lisinopril. intravenous heparin and intravenous nitroglycerin.
Comment on this ECG ?
Eighty-eight year old gentleman with severe multi-vessel coronary artery disease
Clinical History 279
Eighty-eight year old gentleman with severe multi-vessel coronary artery disease and severe left ventricular systolic dysfunction who is being evaluated for coronary artery bypass graft surgery. His medications included aspirin, digoxin, furosemide, captopril and amiodarone.
Comment on this ECG ?
Eighty-eight year old gentleman with severe multi-vessel coronary artery disease and severe left ventricular systolic dysfunction who is being evaluated for coronary artery bypass graft surgery. His medications included aspirin, digoxin, furosemide, captopril and amiodarone.
Comment on this ECG ?
Seventy-five year old gentleman who underwent unsuccessful percutaneous transluminal coronary angioplasty
Clinical History 274
Seventy-five year old gentleman who underwent unsuccessful percutaneous transluminal coronary angioplasty of his right coronary artery referred immediately for coronary artery bypass graft surgery.
Comment on this ECG ?
Seventy-five year old gentleman who underwent unsuccessful percutaneous transluminal coronary angioplasty of his right coronary artery referred immediately for coronary artery bypass graft surgery.
Comment on this ECG ?
Seventy-four year old gentleman status post coronary artery bypass surgery several days prior to this electrocardiogram.
Clinical History 262
Seventy-four year old gentleman status post coronary artery bypass surgery several days prior to this electrocardiogram. Comorbidities include hypertension, hyperlipidemia and postoperative paroxysmal atrial fibrillation. Medications at the time of this electrocardiogram included aspirin and atenolol.
Comment on this ECG ?
Seventy-four year old gentleman status post coronary artery bypass surgery several days prior to this electrocardiogram. Comorbidities include hypertension, hyperlipidemia and postoperative paroxysmal atrial fibrillation. Medications at the time of this electrocardiogram included aspirin and atenolol.
Comment on this ECG ?
Seventy-six year old woman status post aorto-femoral bypass surgery one day prior to this electrocardiogram
Clinical History 258
Seventy-six year old woman status post aorto-femoral bypass surgery one day prior to this electrocardiogram who suffered an acute myocardial infarction and cardiogenic shock. She had a successful percutaneous transluminal coronary angioplasty to a large left circumflex coronary artery. She developed interval pneumonia, acute renal failure and an anoxic encephalopathy. She ultimately expired during the same hospitalization.
Comment on this ECG ?
Seventy-six year old woman status post aorto-femoral bypass surgery one day prior to this electrocardiogram who suffered an acute myocardial infarction and cardiogenic shock. She had a successful percutaneous transluminal coronary angioplasty to a large left circumflex coronary artery. She developed interval pneumonia, acute renal failure and an anoxic encephalopathy. She ultimately expired during the same hospitalization.
Comment on this ECG ?
Seventy-four year old gentleman with a history of hypertension, non-insulin requiring diabetes mellitus
Clinical History 249
Seventy-four year old gentleman with a history of hypertension, non-insulin requiring diabetes mellitus and hyperlipidemia who presented urgently to the hospital with severe anterior precordial chest discomfort and the above electrocardiogram. The patient underwent an urgent cardiac catheterization and percutaneous transluminal coronary angioplasty of the left anterior descending coronary artery.
Comment on this ECG ?
Seventy-four year old gentleman with a history of hypertension, non-insulin requiring diabetes mellitus and hyperlipidemia who presented urgently to the hospital with severe anterior precordial chest discomfort and the above electrocardiogram. The patient underwent an urgent cardiac catheterization and percutaneous transluminal coronary angioplasty of the left anterior descending coronary artery.
Comment on this ECG ?
Seventy-four year old woman who was accepted in hospital transfer after presenting earlier
Clinical History 237
Seventy-four year old woman who was accepted in hospital transfer after presenting earlier the same day with acute onset chest discomfort consistent with acute myocardial injury. Serial cardiac enzymes documented an acute myocardial infarction She continued to demonstrate post-infarction angina and was transferred for cardiac catheterization. Her cardiac catheterization demonstrated severe right coronary artery disease and a successful angioplasty was performed.
Comment on this ECG ?
Seventy-four year old woman who was accepted in hospital transfer after presenting earlier the same day with acute onset chest discomfort consistent with acute myocardial injury. Serial cardiac enzymes documented an acute myocardial infarction She continued to demonstrate post-infarction angina and was transferred for cardiac catheterization. Her cardiac catheterization demonstrated severe right coronary artery disease and a successful angioplasty was performed.
Comment on this ECG ?
Forty-six year old gentleman accepted in hospital transfer two days after the sudden onset
Clinical History 229
Forty-six year old gentleman accepted in hospital transfer two days after the sudden onset of severe anterior chest discomfort with radiation to both arms. The patient received urgent intravenous thrombolytic therapy. Serial cardiac enzyme serum analysis confirmed a large myocardial infarction. Medications at the time of this electrocardiogram included metoprolol, intravenous heparin and aspirin. The patient underwent a cardiac catheterization demonstrating a severe proximal right coronary artery stenosis and subsequent successful percutaneous transluminal coronary angioplasty.
Comment on this ECG ?
Forty-six year old gentleman accepted in hospital transfer two days after the sudden onset of severe anterior chest discomfort with radiation to both arms. The patient received urgent intravenous thrombolytic therapy. Serial cardiac enzyme serum analysis confirmed a large myocardial infarction. Medications at the time of this electrocardiogram included metoprolol, intravenous heparin and aspirin. The patient underwent a cardiac catheterization demonstrating a severe proximal right coronary artery stenosis and subsequent successful percutaneous transluminal coronary angioplasty.
Comment on this ECG ?
Thirty-nine year old gentleman referred for a cardiac catheterization in the setting
Clinical History 224
Thirty-nine year old gentleman referred for a cardiac catheterization in the setting of acute chest discomfort onset and suspected acute myocardial injury. His cardiac catheterization demonstrated an advanced stenosis of the right coronary artery. The patient underwent successful percutaneous transluminal rotational atherectomy of the distal right coronary artery. The electrocardiogram remained unchanged both before and after the procedure.
Comment on this ECG ?
Thirty-nine year old gentleman referred for a cardiac catheterization in the setting of acute chest discomfort onset and suspected acute myocardial injury. His cardiac catheterization demonstrated an advanced stenosis of the right coronary artery. The patient underwent successful percutaneous transluminal rotational atherectomy of the distal right coronary artery. The electrocardiogram remained unchanged both before and after the procedure.
Comment on this ECG ?
Fifty-six year old gentleman status post an inferior myocardial infarction two years prior
Clinical History 204
Fifty-six year old gentleman status post an inferior myocardial infarction two years prior to this electrocardiogram subsequently followed by a cardiac catheterization and multi-vessel coronary artery bypass graft surgety. He is presently without symptoms. His past medical history includes hypercholesterolemia. Medications at the time of this electrocardiogram included lovastatin and aspirin.
Comment on this ECG ?
Fifty-six year old gentleman status post an inferior myocardial infarction two years prior to this electrocardiogram subsequently followed by a cardiac catheterization and multi-vessel coronary artery bypass graft surgety. He is presently without symptoms. His past medical history includes hypercholesterolemia. Medications at the time of this electrocardiogram included lovastatin and aspirin.
Comment on this ECG ?
Sixty-seven year old woman with severe left ventricular systolic dysfunction secondary to ischemic heart disease
Clinical History 199
Sixty-seven year old woman with severe left ventricular systolic dysfunction secondary to ischemic heart disease who represents to the hospital with an acute chest discomfort syndrome, persistent vomiting and blurred vision. The patient has severe chronic congestive heart failure and is currently on home dobutamine. She is status post remote coronary artery bypass graft surgery and ventricular aneurysmectomy.
Comment on this ECG ?
Sixty-seven year old woman with severe left ventricular systolic dysfunction secondary to ischemic heart disease who represents to the hospital with an acute chest discomfort syndrome, persistent vomiting and blurred vision. The patient has severe chronic congestive heart failure and is currently on home dobutamine. She is status post remote coronary artery bypass graft surgery and ventricular aneurysmectomy.
Comment on this ECG ?
Seventy year old gentleman with a two day history of intermittent chest discomfort,
Clinical History 182
Seventy year old gentleman with a two day history of intermittent chest discomfort, nausea and vomiting who presented acutely to the hospital emergency room. A subsequent urgent cardiac catheterization demonstrated a 100% left anterior descending coronary artery occlusion with apical left ventricular aneurysm formation.
Comment on this ECG ?
Seventy year old gentleman with a two day history of intermittent chest discomfort, nausea and vomiting who presented acutely to the hospital emergency room. A subsequent urgent cardiac catheterization demonstrated a 100% left anterior descending coronary artery occlusion with apical left ventricular aneurysm formation.
Comment on this ECG ?
Seventy-four year old woman with coronary artery disease who presents to the hospital with a one hour history
Clinical History 180
Seventy-four year old woman with coronary artery disease who presents to the hospital with a one hour history of acute chest discomfort consistent with myocardial injury.
Comment on this ECG ?
Seventy-four year old woman with coronary artery disease who presents to the hospital with a one hour history of acute chest discomfort consistent with myocardial injury.
Comment on this ECG ?
Seventy-one year old woman with acute onset chest discomfort of two hours duration who presented
Clinical History 178
Seventy-one year old woman with acute onset chest discomfort of two hours duration who presented to the emergency room The above electrocardiogram was obtained. An urgent cardiac catheterization demonstrated a 90% proximal right coronary artery obstruction with thrombus. Successful acute percutaneous transluminal coronary angioplasty was performed without complication.
Comment on this ECG ?
Seventy-one year old woman with acute onset chest discomfort of two hours duration who presented to the emergency room The above electrocardiogram was obtained. An urgent cardiac catheterization demonstrated a 90% proximal right coronary artery obstruction with thrombus. Successful acute percutaneous transluminal coronary angioplasty was performed without complication.
Comment on this ECG ?
Seventy-one year old woman status post a myocardial infarction twenty-five years prior
Clinical History 172
Seventy-one year old woman status post a myocardial infarction twenty-five years prior to this electrocardiogram who presents with acute onset chest discomfort. Co-morbidities include tobacco use, primary hyperthyroidism and long-standing hypertension. Serial cardiac enzyme analysis confirmed acute myocardial injury.
Comment on this ECG ?
Seventy-one year old woman status post a myocardial infarction twenty-five years prior to this electrocardiogram who presents with acute onset chest discomfort. Co-morbidities include tobacco use, primary hyperthyroidism and long-standing hypertension. Serial cardiac enzyme analysis confirmed acute myocardial injury.
Comment on this ECG ?
Seventy-seven year old woman admitted to the hospital with an acute inferior myocardial infarction
Clinical History 163
Seventy-seven year old woman admitted to the hospital with an acute inferior myocardial infarction who is now referred for coronary artery bypass graft surgery. An echocardiogram confirmed inferoposterior akinesis. Her medications included aspirin, intravenous heparin, intravenous nitroglycerin and metoprolol.
Comment on this ECG ?
Seventy-seven year old woman admitted to the hospital with an acute inferior myocardial infarction who is now referred for coronary artery bypass graft surgery. An echocardiogram confirmed inferoposterior akinesis. Her medications included aspirin, intravenous heparin, intravenous nitroglycerin and metoprolol.
Comment on this ECG ?
Sixty-six year old woman who underwent persantine thallium stress testing demonstrating a large area of myocardial ischemia
Clinical History 140
Sixty-six year old woman who underwent persantine thallium stress testing demonstrating a large area of myocardial ischemia. The patient subsequently underwent an angioplasty to her left anterior descending coronary artery complicated by acute closure and infarction. This electrocardiogram was obtained at the time of the percutaneous transluminal coronary angioplasty.
Comment on this ECG ?
Sixty-six year old woman who underwent persantine thallium stress testing demonstrating a large area of myocardial ischemia. The patient subsequently underwent an angioplasty to her left anterior descending coronary artery complicated by acute closure and infarction. This electrocardiogram was obtained at the time of the percutaneous transluminal coronary angioplasty.
Comment on this ECG ?
Seventy-seven year old woman who was accepted in hospital transfer after suffering
Clinical History 135
Seventy-seven year old woman who was accepted in hospital transfer after suffering an acute inferior myocardial infarction ten days priorto this electrocardiogram. Co-morbidities include hypertension and a prior cerebral aneurysm repair. Her medications included nifedipine, triamterene/hydrochlorothiazide and aspirin.
Comment on this ECG ?
Seventy-seven year old woman who was accepted in hospital transfer after suffering an acute inferior myocardial infarction ten days priorto this electrocardiogram. Co-morbidities include hypertension and a prior cerebral aneurysm repair. Her medications included nifedipine, triamterene/hydrochlorothiazide and aspirin.
Comment on this ECG ?
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