This strip was obtained from a woman who presented to her doctor’s office with hypertension. While there is some artifact in the baseline, it is possible to determine the presence of P waves, thanks in part to having two leads to assess. We have provided an unmarked version of the strip for you to use, and also a marked version for the sake of this discussion.
Thank you to Alikuni Kllany from Toronto for donating these ECGs. They are from a 59-year-old man who has a history of hypertension and depression. Last year, he was on atenolol when he experienced a brief syncopal episode and bradycardia. He was taken off atenolol and started on amlodipine 5 mg. He also takes ramipril 10 mg, atorvastatin 40 mg, and tamsulosin .4 mg. He continues to have bradycardia and dizziness.
Patient's clinical data: 81-year-old black man
The computer interpreted this ECG as:
Sinus bradycardia 1st degree AV block
ST abnormality, possible digitalis effect
When compared with ECG of (expunged)
PR interval has increased
This week, in addition to my own blog, I'm going to feature a guest case study by Guru member Vince DiGiulio, EMT-CC. This past Monday, Vince messaged me (along with Dr. Ken Grauer) on Facebook and requested my input and opinion on these serial ECGs. With Vince's blessing, he gave me permission to use any of his original 12-lead ECGs here on the Guru. Of his 6 ECGs, I've decided to post 4 of them here.
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