Learning Cardiology

Case History:  A 46-year old female presents with history of palpitations.  At the time of palpitations, she also had rapid neck pulsations.  She presented to emergency and an ECG was done.  What are the findings?  What is the diagnosis?   Click here to reveal the answer The ECG shows a regular narrow complex tachycardia (ventricular rate of approximately 250/min). The P waves are not clearly visible, but there is a small deflection at the end of QRS in various leads. In lead I, this is pseudo r' and in leads this is pseudo s wave. The patient was found to have AVNRT on EPS and slow pathway was ablated successfully.  

 Case 1. A 23-year old gentleman presented with history of chest pain and shortness of breath.  This was the ECG at the time of presentation.  What are the findings? What is the diagnosis? Answer: ECG shows Sinus tachycardia and S1Q3T3 pattern.  S1Q3T3 pattern is a specific sign of acute pulmonary embolism. CTPA confirmed the diagnosis.   Patient underwent thrombolysis with Tenecteplase successfully with resolution of symptoms.