ECG Guru - Instructor Resources - Congestive cardiomyopathy https://www.ecgguru.com/ecg/congestive-cardiomyopathy en Jason’s blog: ECG Challenge of the Week for July 29th – August 5th. What's causing this rare combination? https://www.ecgguru.com/blog/jason%E2%80%99s-blog-ecg-challenge-week-july-29th-%E2%80%93-august-5th-whats-causing-rare-combination <div class="field field-name-field-blog-image field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/blog/jason%E2%80%99s-blog-ecg-challenge-week-july-29th-%E2%80%93-august-5th-whats-causing-rare-combination"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/ECG%20of%20the%20Week%201f.png" width="765" height="862" alt="" /></a></div></div></div><div class="field field-name-body field-type-text-with-summary field-label-hidden"><div class="field-items"><div class="field-item even" property="content:encoded"><p>I performed this 12-lead ECG (Fig. 1) several years ago in the medical intensive care unit (MICU) while standing at the patient's bedside.&nbsp; As I was recording the ECG, I distinctly remember thinking to myself:&nbsp; <em>"this patient looks REALLY sick!"</em> for being as relatively young as he was.&nbsp; Immediately after I printed out the hardcopy, I reviewed the computer's interpretive statements at the top of the page.&nbsp; The computer listed an uncommon pair of findings which I confirmed to be true.&nbsp; I asked the assigned nurse if her patient had the clinical condition that this combination is <em>highly suggestive</em> of.&nbsp; She shrugged her shoulders at me and said she didn't know.&nbsp; I consulted the patient's computerized record and right there listed at the top of their "active problems" was the very condition I suspected the patient of having.&nbsp; <br /><span style="text-decoration: underline;"><strong><br />Patient's clinical data:</strong></span>&nbsp; 49-year-old black man with history of Type II diabetes mellitus (DM) and <em>this other clinical condition.&nbsp; </em></p> <p><span style="text-decoration: underline;"><strong>Fig. 1:</strong></span>&nbsp; I performed this ECG exactly 5 months and 5 days <em>before</em> the ECG in Fig. 2.</p> <p><span style="text-decoration: underline;"><strong>Fig. 2:</strong></span>&nbsp; This ECG was performed on a outpatient basis during a follow-up appointment with their physician.&nbsp; Have things improved or have they gotten worse? </p> <p><span style="text-decoration: underline;"><strong>QUESTIONS:</strong></span>&nbsp; In fig. 1, what rare combination of findings are present and what are those two findings <em>highly suggestive</em> of?&nbsp; What would explain the dramatic changes seen in Fig. 2? &nbsp; </p> <p><span style="text-decoration: underline;"><strong>HINT:</strong></span>&nbsp; Figures 1 and 2 both look dissimilar enough (esp. given the sequence in which they were recorded) that one might suspect they're from two completely different patients and technically that assumption would not be entirely wrong.&nbsp; Of what am I hinting towards?&nbsp; To be clear, both of these ECGs were performed on the same 49-year-old black male patient. &nbsp;&nbsp;</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/156/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Jason’s blog: ECG Challenge of the Week for July 29th – August 5th. 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What&amp;#039;s causing this rare combination? 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >5</span></span> <span class="total-votes">(<span >1</span> vote)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-JgBxGIRLP4zSYRqHlqnLnJrtjVKRecfEy0SNbF6Opw0" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fblog%2Fjason%25E2%2580%2599s-blog-ecg-challenge-week-july-29th-%25E2%2580%2593-august-5th-whats-causing-rare-combination&amp;title=Jason%E2%80%99s%20blog%3A%20ECG%20Challenge%20of%20the%20Week%20for%20July%2029th%20%E2%80%93%20August%205th.%20What%27s%20causing%20this%20rare%20combination%3F"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Sun, 29 Jul 2012 07:23:30 +0000 jer5150 256 at https://www.ecgguru.com https://www.ecgguru.com/blog/jason%E2%80%99s-blog-ecg-challenge-week-july-29th-%E2%80%93-august-5th-whats-causing-rare-combination#comments