SPOTTERS(ECG,CXR,ECHO)

DR. MAHENDRACARDIOLOGY,JIPMER

1.A 75 year old man with a history of COPD presents with fever and increased sputum production. An ECG is taken in the emergency department. What does it show?

• Diagnosis: polymorphic atrial tachycardia• Ecg feature-• Heart rate > 100 bpm (usually 100-150 bpm; may be as high as 250 bpm).• Irregularly irregular rhythm with varying PP, PR and RR intervals.• At least 3 distinct P-wave morphologies in the same lead.• Isoelectric baseline between P-waves (i.e. no flutter waves).• Absence of a single dominant atrial pacemaker (i.e. not just sinus rhythm with frequent

PACs).• Some P waves may be nonconducted• others may be aberrantly conducted to the ventricles.

2.68 yr old female with old MI, c/o palpitation ,giddiness ecg show??

• Irregularly irregular rhythm • Rate approx. 200/min• Initially narrow complex change into wide complex tachycardia with changing

axis.• p/o• AF with aberrancy• Preexcited AF • VT

3.Presented with palpitation

After adenosine

• Regular narrow complex tachycardia• Short RP• Rate 150/min, normal axis• Pseudo s and r present • Respond with adenosine • p/o AVNRT

4.18 year old man signs up to join the army. He is fit and well. This is his ECG taken at his medical examination. Is it normal

• ECG is characteristic of Brugada Syndrome (Type 1)•

5.Diagnosis??

• R on T phenomenon:• sinus rhythm with frequent PVCs in a pattern of ventricular bigeminy.• QT interval is markedly prolonged (at least 600ms), with each PVC falling on the

preceding T wave (= ‘R on T’ phenomenon).• ECG is extremely high risk for TdP

6.diagnosis??

• HYPOKALEMIA• Typical U wave seen• Camel hump sign• Prolonged repolarisation

7.Diagnosis ??

• Exercise stress test in a patient with CPVT. • Progressively worsening ventricular arrhythmias are observed during exercise.• Typical bidirectional VT develops after 1 minute of exercise • Arrhythmias rapidly recede during recovery.

8.

Atrial lead dislodgment to ventricle

9.c/o recurrent palpitation diagnosis?

Typical atrial flutter

10.Pressure tracing interpretation ??

11.6 yr old child with cyanosisleft side LV/RV tracing, rt side PA tracing

• RV and Ao pressures are equal• PA pressures –Normal• Diagnosis

• VSD,PS physiology

12.60 yr old male with cardiogenic shockxray taken after cardiac intervention

28

- The end of the balloon should be just distal (1-2 cm) to the takeoff of the left subclavian artery

- Position should be confirmed by fluoroscopy or chest x-ray

iabp ballon positioning

THANK YOU