Normal ECG. A 55 year old man with 4 hours of "crushing" chest pain.

Normal ECG

A 55 year old man with 4 hours of "crushing" chest pain.

A 63 year old woman with 10 hours of chest pain and sweating.

A 60 year old woman with 3 hours of chest pain.

A 53 year old man with Ischaemic Heart Disease.

A 79 year old man with 5 hours of chest pain.

An 83 year old man with aortic stenosis.

A 75 year old woman with loud first heart sound and mid-diastolic murmur.

A 59 year old woman with chronic bronchitis.

An 84 year old woman with hypertension

A 73 year old woman with dizziness.

A 70 year old man with exercise intolerance.

An 82 year old lady with dizzy spells

A 55 year old man with 4 hours of "crushing" chest pain.

A 90 year old lady with syncope.

A 34 year old woman with asthma

A 60 year old man with HTN

A48 year old man with palpitation

A 76 year old man with SOB

A 60 year old woman with HTN

A 68 year old women on Digoxin complaining of fatigue

A 57 year old woman with palpitations

A woman with Romano-Ward Syndrome

QTc

Normal QTc• Men < 0.43

– borderline o.43-0.45

– prolonged >0.45

• Women < 0.43 – borderline o.43-0.47

– prolonged >0.47

A 50 year old man with chest pain for 2-4 hours

A 45 year old women with palpitation and a history of CRF

A 69 year old man 2weeks post IWMI

A 60 year old man with IHD

A 36 year old woman with recurrent blackouts

A 60 year old male with 2 hours of “crushing” chest pain suddenly collapses

A 72 year old man with a permanent pacemaker

What is the rhythm?

Dual chamber pacer with an ICD

A 25 year old man with bouts of tachycardia

short PR interval, less than 3 small squares (120 ms)

slurred upstroke to the QRS indicating pre-excitation (delta wave)

broad QRS

secondary ST and T wave changes

Localising the accessory pathway

An accessory pathway, bundle of Kent, exists between atria and ventricles and causes

early depolarisation of the ventricle. The location of the pathway may be deduced as follows:-

LOCATION V1 V2 QRS axisleft posteroseptal (type A) +ve +ve leftright lateral (type B) -ve -ve leftleft lateral (type C) +ve +ve inferior (90 degrees)right posteroseptal -ve -ve leftanteroseptal -ve -ve normal

Wolf-Parkinson-White syndrome

A 47 year old man with a long history of palpitations and blackouts.

A 23 year old male with palpitations

A 56 year old man with SOB and raises JVP

A 50 year old man with palpitations

A 49 year old woman with pleuritic chest pain and SOB

A 58 year old man on hemodialysis presents with weakness

A 28 year old woman with prolonged

vomiting

A 64 year old woman on digoxin