ECG Interpretation Case 5

A 51 year old male came to the ED with ongoing chest pain  since 4 hours.
There is no past medical history.
No history of Smoking and alcohol intake.
Vitals
B.P 130/70 mmHg
H.R 90/min
The ECG is displayed below.
Interpret the ECG and leave your comments in the box below.

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ECG Interpretation Case 4

A 65 years old male came to the ED with complain of  retrosternal chest pain and breathlessness. Patient is known diabetic since 15 years. His ECG is displayed below.

O/E

B.P - 80/60 mmHg

H.R - 50/min

What Should be the next step in the management of this patient?

Hello Readers, Thanks for your valuable comments. I am publishing the best Interpretation Given by  Ken Grauer, MD  of ECG Interpretation . 

Interesting 12-lead tracing (though a bit difficult to make out given suboptimal quality). Nevertheless - there is sinus bradycardia at ~50/minute with 1st degree AV block and complete LBBB. In addition - there is definite inferior ST elevatation (lead III > II) - with reciprocal ST depression in aVL. In addition - there are primary ST changes in V4,V5,V6 - all suggesting a proximal RCA lesion in a patient with a left-dominant circulation - so urgent PCI in this hypotensive patient large evolving acute MI. Pacing may soon be needed (complete LBBB plus 1st degree). VERY INTERESTING tracing - THANKS for posting!

For anyone interested in a user-friendly guide for determining what is the likely culprit artery (as well as likely conduction defects from various MIs) - GO TO: https://www.kg-ekgpress.com/ecg_-_coronary_anatomy-mi_localization/

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Which of the following will be the most appropriate initial therapy?

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A 50 year old gentleman is admitted to the CCU with an acute Inferior wall infarction. Three hours after the admission his B.P is 90/50 mmHg. The heart rate is 38 beats per minute with sinus rhythm. Which of the following will be the most appropriate initial therapy?

Immediate insertion of temporary pacemaker

Intravenous administration of of Isoproterenol 5 micrograms/min

Intravenous administration of Dobutamine 0.35 mg/min

Administration of Intravenous Normal saline, 300 ml over 15 mins

Intravenous administration of atropine sulfate , 0.6 mg

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Which of the following laboratory results would be expected?

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A 50 year old gentleman with a history of hypertension and high cholesterol presents to the emergency department with pain in chest for one hour. He describes a substernal chest pressure associated with shortness of breath and sweating. His ECG shows ST elevations consistent with myocardial infarction. Which of the following laboratory results would be expected?

 Elevated myoglobin, normal troponin I, and normal CK-MB

Normal myoglobin, elevated troponin I, and normal CK-MB

Normal myoglobin, normal troponin I, and elevated CK-MB

Normal myoglobin, normal troponin I, and normal CK-MB

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ECG Interpretation Case 3

A 85 year old Male came to the Emergency Department with C/O chest pain. There is no history of another associated diseases. ECG is attached.
O/E
B.P 130/70mmHg
H/R 150/min
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What is the Mechanism of Action of Drug X ?

A 60 year old man with a histoty of Diabetes, hypertension and congestive heart failure was brought to the ER after he complained of blurred vision and headache. He was found to have Blood Pressure of 220/90 mm Hg. The intern who examined her wanted to give her drug X, but the attending doctor rejects this choice because of its tendency to cause compensatory tachycardia and exacerbate fluid retention. The drug can also cause lupus like syndrome with long term use. What is the mechanism of action of Drug X?

Blocks Calcium Channels
Increases Production of cGMP
Decreases Production of cGMP
Inhibits Angiotensin Converting Enzyme
Inhibits carbonic Anhydrase

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ECG Interpretation - Case 2

A 46 year old gentleman came to the Emergency department with c/o sudden dyspnea. Patient had similar episode of dyspnea two days earlier which was associated with profuse sweating. Patient is a reformed smoker and a social drinker. ECG is displayed below. Let`s interpret the ECG and decide the next step in the management.


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Choose The Most Likely Diagnosis

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A 70 year old woman with a history of breast cancer and tobacco use complains of dizziness and dyspnea on exertion. Her heart sounds are distant and her systolic blood pressure is noted to markedly decrease with inspiration. Which of the following is the likely diagnosis?

Restrictive Cardiomyopathy

Mitral Valve Regurgitation

Congestive Heart Failure

Pulmonary Embolism

Cardiac Tamponade

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What is most likely Diagnosis?

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A 30 year old female with no significant past medical history is 42 weeks pregnant and labor has just begun. She begins to complain of difficulty in breathing which worsens throughout delivery to the point of requiring intubation. She had never previously complained of any shortness of breath or chest pain. Her temperature is 37.0, blood pressure 90/60, heart rate 135, respirations 25, and oxygen saturation 100% on 60% FiO2 on the ventilator. Physical examination reveals diffuse pulmonary rales, a II/IV early diastolic murmur, and no lower extremity edema. Laboratory studies are normal. ECG shows sinus tachycardia and left atrial enlargement. Her chest x-ray has pulmonary edema. Which of the following is the most likely diagnosis?

Aortic Dissection

Dissection of Coronary Artery

Aortic valve Stenosis

Mitral Valve Stenosis




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ECG Interpretation - Case 1

Interpret The ECG and leave you diagnosis in the Comment Box Below.......















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Find the Culprit Drug

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A 60 year old gentleman with a history of dyslipidemia, hypertension and CHF presents to the emergency department with acute onset swelling of the lips, eyes, and tongue causing airway obstruction and respiratory distress. He also has an urticarial rash. Which of the following medications is the likely culprit of his current symptoms?

 Pindolol

Clonidine

Felodipine

 Captopril

Methyldopa

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Cardiology MCQ - Find the Associated Cardiac Disorder

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A 27 year old male with a history of ectopia lentis presents for a general physical examination. He is noted to have pectus excavatum, pes planus, a high arched palate, and a positive wrist and thumb sign. Which of the following cardiac disorders is associated with his condition?

Ebsteins Anomaly

Coarctation of Aorta

Mitral Valve Prolapse

Ventricular Septal Defect

Aortic Valve Stenosis

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Choose The Right Antihypertensive

A 60 year old African American gentlemen with a history of COPD is diagnosed with hypertension. Laboratory studies reveal a creatinine of 3.2 mg/dL and a potassium level of 5.2 mg/dL. Which of the following medications is appropriate to treat his hypertension?

Spironolactone
Amlodipine
Hydrochlorothiazide
Enalapril
Propranolol

Click one out of 5 option to choose your answer

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