Sixty-two year old gentleman who is undergoing preoperative anesthesia clearance priorto planned rotator cuff repair
Clinical History 09
Sixty-two year old gentleman who is undergoing preoperative anesthesia clearance priorto planned rotator cuff repair. His past medical history is notable for hypertension but no known cardiac disease. His medications included verapamil.
Comment on this ECG ?
Sixty-two year old gentleman who is undergoing preoperative anesthesia clearance priorto planned rotator cuff repair. His past medical history is notable for hypertension but no known cardiac disease. His medications included verapamil.
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Thirty-nine year old woman, unrestrained passenger who suffered an aortic transection
Clinical History 08
Thirty-nine year old woman, unrestrained passenger who suffered an aortic transection distal to the left subclavian artery from a motor vehicle accident. This electrocardiogram was taken postoperatively shortly after thoracic aorta repair.
Comment on this ECG ?
Thirty-nine year old woman, unrestrained passenger who suffered an aortic transection distal to the left subclavian artery from a motor vehicle accident. This electrocardiogram was taken postoperatively shortly after thoracic aorta repair.
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Forty-one year old gentleman with myelodysplasia syndrome
Clinical History 06
Forty-one year old gentleman with myelodysplasia syndrome and insulin requiring diabetes mellitus admitted for a bone marrow transplantation. His serum potassium at the time of this electrocardiogram was 3.4 meq/L
Comment on this ECG ?
Forty-one year old gentleman with myelodysplasia syndrome and insulin requiring diabetes mellitus admitted for a bone marrow transplantation. His serum potassium at the time of this electrocardiogram was 3.4 meq/L
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Seventy year old woman who presents for a general physical examination.
Clinical History 05
Seventy year old woman who presents for a general physical examination. She has a history of coronary artery obstructive disease and is status post a myocardial infarction of unknown location four years prior to this electrocardiogram. Other co-morbid conditions include extensive past tobacco use, hypertension and gastro esophageal reflux disease. Her medications at the time of this electrocardiogram included potassium, thyroxin, triamterene/hydrochlorothiazide and Naprosyn.
Comment on this ECG ?
Seventy year old woman who presents for a general physical examination. She has a history of coronary artery obstructive disease and is status post a myocardial infarction of unknown location four years prior to this electrocardiogram. Other co-morbid conditions include extensive past tobacco use, hypertension and gastro esophageal reflux disease. Her medications at the time of this electrocardiogram included potassium, thyroxin, triamterene/hydrochlorothiazide and Naprosyn.
Comment on this ECG ?
Fifty-two year old gentleman who presents for a routine physical examination
Clinical History 02
Fifty-two year old gentleman who presents for a routine physical examination in the preventive medicine department. His past medical history includes elevated triglycerides and a low HDL cholesterol value. He otherwise remains in good health.
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Fifty-two year old gentleman who presents for a routine physical examination in the preventive medicine department. His past medical history includes elevated triglycerides and a low HDL cholesterol value. He otherwise remains in good health.
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Eighteen year old gentleman with a seizure disorder
Clinical History 01
Eighteen year old gentleman with a seizure disorder who returns for outpatient neurology follow-up. His medications included phenytoin, carbamazepine and diazepam.
Comment on this ECG ?
Eighteen year old gentleman with a seizure disorder who returns for outpatient neurology follow-up. His medications included phenytoin, carbamazepine and diazepam.
Eighty-seven year old woman with severe osteoarthritis
Clinical History 631
Eighty-seven year old woman with severe osteoarthritis who seeks a second opinion secondary to progressive shortness of breath. Her medications included multivitamins and lisinopril.
Comment on this ECG ?
Eighty-seven year old woman with severe osteoarthritis who seeks a second opinion secondary to progressive shortness of breath. Her medications included multivitamins and lisinopril.
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.
Forty-two year old gentleman who is self-referred for evaluation of heart palpitations
Clinical History 68
Forty-two year old gentleman who is self-referred for evaluation of heart palpitations. His medications included ibuprofen and ranitidine.
What is your spot diagnosis ?
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Forty-two year old gentleman who is self-referred for evaluation of heart palpitations. His medications included ibuprofen and ranitidine.
What is your spot diagnosis ?
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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 ?
Forty-eight year old gentleman with multiple prior myocardial infarctions
Clinical History 277
Forty-eight year old gentleman with multiple prior myocardial infarctions who was admitted recently to the hospital with severe congestive heart failure. The patient subsequently expired.
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Forty-eight year old gentleman with multiple prior myocardial infarctions who was admitted recently to the hospital with severe congestive heart failure. The patient subsequently expired.
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Twenty-nine year old gentleman with hypertrophic obstructive cardiomyopathy
Clinical History 276
Twenty-nine year old gentleman with hypertrophic obstructive cardiomyopathy status post recent surgical myectomy.
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Twenty-nine year old gentleman with hypertrophic obstructive cardiomyopathy status post recent surgical myectomy.
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Seventy-five year old woman with coronary artery disease status post angioplasty and coronary artery bypass graft surgery
Clinical History 270
Seventy-five year old woman with coronary artery disease status post angioplasty and coronary artery bypass graft surgery who is currently being seen in the outpatient cardiology clinic. Other co-morbidities include non-insulin requiring diabetes mellitus and hypertension. This patient developed progressive heart block shortly after this electrocardiogram and permanent pacemaker implantation was undertaken. Medications at the time of this electrocardiogram included captopril, diltiazem, furosemide, aspirin, topical nitrates and simvastatin.
Comment on this ECG ?
Seventy-five year old woman with coronary artery disease status post angioplasty and coronary artery bypass graft surgery who is currently being seen in the outpatient cardiology clinic. Other co-morbidities include non-insulin requiring diabetes mellitus and hypertension. This patient developed progressive heart block shortly after this electrocardiogram and permanent pacemaker implantation was undertaken. Medications at the time of this electrocardiogram included captopril, diltiazem, furosemide, aspirin, topical nitrates and simvastatin.
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Seventy-seven year old woman with hypertension, hyperlipidemia and angina pectoris
Clinical History 269
Seventy-seven year old woman with hypertension, hyperlipidemia and angina pectoris who returns for routine cardiac follow-up in the setting of atherosclerotic coronary artery disease. She is status post a percutaneous revascularization procedure to her left circumflex coronary artery, mitral valve replacement and a remote myocardial infarction of unknown location. Her medications included ticlodipine, Prilosec and aspirin.
Comment on this ECG ?
Seventy-seven year old woman with hypertension, hyperlipidemia and angina pectoris who returns for routine cardiac follow-up in the setting of atherosclerotic coronary artery disease. She is status post a percutaneous revascularization procedure to her left circumflex coronary artery, mitral valve replacement and a remote myocardial infarction of unknown location. Her medications included ticlodipine, Prilosec and aspirin.
Comment on this ECG ?
Forty year old gentleman with a history of an enlarged heart'since a young age who seeks a cardiac evaluation.
Clinical History 268
Forty year old gentleman with a history of'an enlarged heart'since a young age who seeks a cardiac evaluation. A prior echocardiogram demonstrated evidence of Ebstein's anomaly.
Comment on this ECG ?
Forty year old gentleman with a history of'an enlarged heart'since a young age who seeks a cardiac evaluation. A prior echocardiogram demonstrated evidence of Ebstein's anomaly.
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Fifty year old gentleman who presents to the hospital with a clinical syndrome consistent with crescendo angina.
Clinical History 260
Fifty year old gentleman who presents to the hospital with a clinical syndrome consistent with crescendo angina. A cardiac catheterization demonstrated a subtotal proximal occlusion of the left anterior descending coronary artery. This stenosis was successfully angioplastied. The patient subsequently presented to the hospital with recurrent chest pain and this electrocardiogram. A repeat cardiac catheterization demonstrated a patent PTCAsite, however a new 90% stenosis of the right coronary artery was found and successfully angioplastied. The patient suffered a small inferior myocardial infarction as serial serum cardiac enzymes were elevated.
Comment on this ECG ?
Fifty year old gentleman who presents to the hospital with a clinical syndrome consistent with crescendo angina. A cardiac catheterization demonstrated a subtotal proximal occlusion of the left anterior descending coronary artery. This stenosis was successfully angioplastied. The patient subsequently presented to the hospital with recurrent chest pain and this electrocardiogram. A repeat cardiac catheterization demonstrated a patent PTCAsite, however a new 90% stenosis of the right coronary artery was found and successfully angioplastied. The patient suffered a small inferior myocardial infarction as serial serum cardiac enzymes were elevated.
Comment on this ECG ?
Fifty-six year old woman with ischemic left ventricular systolic dysfunction and symptoms
Clinical History 259
Fifty-six year old woman with ischemic left ventricular systolic dysfunction and symptoms of advanced congestive heart failure who presents for further outpatient cardiology evaluation. Her medications included digoxin, warfarin, lisinopril, furosemide, potassium and thyroxine.
Comment on this ECG ?
Fifty-six year old woman with ischemic left ventricular systolic dysfunction and symptoms of advanced congestive heart failure who presents for further outpatient cardiology evaluation. Her medications included digoxin, warfarin, lisinopril, furosemide, potassium and thyroxine.
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-one year old woman with recurrent congestive heart failure accepted in hospital transfer for further evaluation.
Clinical History 257
Seventy-one year old woman with recurrent congestive heart failure accepted in hospital transfer for further evaluation. A recent cardiac catheterization demonstrated severe diffuse atherosclerotic coronary disease, moderately severe left ventricular systolic dysfunction with remote anterior, apical and inferior wall myocardial infarctions. Medications at the time of this electrocardiogram included amlodipine, enalapril.furosemide, prazosin and metolazone.
Comment on this ECG ?
Seventy-one year old woman with recurrent congestive heart failure accepted in hospital transfer for further evaluation. A recent cardiac catheterization demonstrated severe diffuse atherosclerotic coronary disease, moderately severe left ventricular systolic dysfunction with remote anterior, apical and inferior wall myocardial infarctions. Medications at the time of this electrocardiogram included amlodipine, enalapril.furosemide, prazosin and metolazone.
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Sixty-six year old gentleman status post recent coronary artery bypass graft surgery,
Clinical History 256
Sixty-six year old gentleman status post recent coronary artery bypass graft surgery, paroxysmal atrial fibrillation and a cerebrovascular accident who returns for a follow-up evaluation after his bypass surgery. Other co-morbidities include hypertension, non-insulin requiring diabetes mellitus and hyperlipidemia.
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Sixty-six year old gentleman status post recent coronary artery bypass graft surgery, paroxysmal atrial fibrillation and a cerebrovascular accident who returns for a follow-up evaluation after his bypass surgery. Other co-morbidities include hypertension, non-insulin requiring diabetes mellitus and hyperlipidemia.
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