A series of ECGs can be a valuable addition to any teacher's collection. This series follows a 75-year-old woman through three days, during which she experienced an acute anterior wall M.I., a catheterization with angioplasty and stents placement.
ECG teaching series
This series of ECG rhythm strips shows a paroxysmal supraventricular tachycardia successfully treated with adenosine. The patient was complaining of a rapid heart rate and palpitations, but was hemodynamically stable. It is not known whether any parasympathetic stimulation, such as a Valsalva maneuver or carotid sinus massage, was used initially.
This series shows the evolution of ECG changes in anterior wall M.I. secondary to occlusion of the proximal left anterior descending artery. The patient is an 88-year-old woman with chest pain. She was designated a "cardiac alert" from the field by paramedics. Her proximal LAD was opened and stented in the cath lab. We do not have follow-up information on her.
In the first ECG shown, we see an irregular tachydysrhythmia. He has had periodic episodes of rapid heart rate since the age of 19, but is in good health otherwise. He is on Flecainide, 200 mg per day. The rhythm might look like atrial fibrillation to many people, but there are signs of regular, fast flutter waves (arrows). The irregularity is caused by variable conduction of the atrial flutter. The QRS is slightly widened, possibly due to the Flecainide, a sodium-channel blocker which slows conduction.
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