A 35 year old man presents with palpitations. He has been drinking heavily with friends over the weekend. This is his ECG. Present your findings and give a diagnosis
👇
◽Presentation

Rate➡️100 – 150
Rhythm➡️Irregularlyirregular
Axis➡️Normal
P-wave➡️No p-wave seen,Fibrillating base line
QRS➡️Narrow
ST/T-wave➡️Normal
QTc/other➡️Normal
👇
◽Diagnosis

This ECG shows atrial fibrillation (AF) with a fast ventricular response

Question 2

A 45 year old business man presents with a feeling that his heart is racing. He also has some shortness of breath. This is his ECG. Present your findings and give a diagnosis.

◽Presentation
👇
Rate➡️150
Rhythm➡️Regular
Axis➡️Normal
PR/P-wave➡️No p-waves. Seesaw baseline
QRS➡️Narrow
QTc/other➡️Normal

◽Diagnosis
👇
This is atrial flutter

A 65 year old man with a history of ischaemic heart disease is found unresponsive. He has no central pulse and is making no respiratory effort. This is his ECG. What is the diagnosis and what will you do?

◽Presentation
👇
Rate➡️150
Rhythm➡️Regular
Axis➡️Left axis deviation
PR/P wave➡️Not visible
QRS➡️Wide
ST/T wave➡️Unable to assess
QTc/other➡️Unable to assess

◽Diagnosis
This is ventricular tachycardia (VT)

A 58 year old man who attends the emergency department with chest pain loses consciousness whilst he is having his initial ECG. He has no central pulse and is taking occasional deep breaths. What is going on?

◽Presentation
👇
Rate➡️Initially 100, then 300
Rhythm➡️Initially regular, then irregular
PR/P wave➡️Initially present, then unable to visualise
QRS➡️Initially narrow, then wide
ST/T wave➡️Initially massive ST elevation in II III and aVF with reciprocal depression in I and aVL. Then unable to visualise
QTc/other➡️Unable to assess

◽Diagnosis
👇
This is ECG initially shows an inferior STEMI, which then deteriorates into ventricular fibrillation (VF).

A 60 year old man presents with tight central chest pain radiating to his left shoulder. This is his initial ECG. Present your findings and give a diagnosis.

◽Presentation
👇
Rate➡️90
Rhythm➡️Regular
Axis➡️Normal
PR/P wave➡️Normal
QRS➡️Narrow
ST/T wave➡️Grossly elevated in V2, V3, V4, V5 and V6. Reciprocal depression in II, III and aVF.
QTc/other➡️Normal

◽Diagnosis
👇
This patient has ST elevation in the anterior and lateral leads. This is therefore an anterolateral ST elevation MI (STEMI).

A 29 year old  presents with central chest pain. She has a history of recent flu-like illness but no significant past medical history. This is her ECG. What is the diagnosis?

Presentation
👇
Rate➡️60
Rhythm➡️Regular
Axis➡️Normal
PR/P wave➡️PR segment depression
QRS➡️Narrow
ST/T wave➡️Widespread ST elevation (saddle shaped)
QTc/other➡️Normal

Diagnosis
👇
The diagnosis is pericarditis. Pericarditis often presents in young people after a history of viral illness. He you can see the characteristic widespread saddle-shaped ST elevation and PR depression.

A 55 year old renal dialysis patient presents to the emergency department having missed his last session of dialysis due to feeling dizzy and unwell. This is his ECG. Present your findings and give a diagnosis.

◽Presentation
👇
Rate➡️100 – 150
Rhythm➡️Irregular
Axis➡️Unable to establish
PR/P wave➡️Not visible
QRS➡️Widened
ST/T ➡️waveMerged with QRS
QTc/other➡️Unable to assess

◽Diagnosis
👇
This is the classic sine wave ECG pattern of severe hyperkalaemia. It can quickly deteriorate into ventricular fibrillation (VF).

A 45 year old man is found collapsed at home. There is no history available. This is his ECG. What is the diagnosis?

◽Presentation
👇
Rate➡️Highly variable – up to 300 bpm
Rhythm➡️Irregular
Axis➡️Unable to assess
PR/P wave➡️Absent during episodes of extreme tachycardia
QRS➡️Wide
ST/T wave➡️Unable to assess
QTc/other➡️Unable to assess

◽Diagnosis
👇
This is a difficult case and shows runs of polymorphic VT or Torsades de pointes.

◽Presentation
👇
Rate➡️64 beat/min
Rhythm➡️Regular
Axis➡️Normal
PR/P wave➡️Constant prolongation of PR interval in lead 2
QRS➡️Normal
ST/T wave➡️Normal
QTc/other➡️Normal

◽Diagnosis
👇
This is a First degree heat block.

◽Presentation
👇
Rate➡️ 75 beat/min
Rhythm➡️irregular
Axis➡️Normal
PR/P wave➡️progressive prolongation of PR interval in lead 2 , followed by a Missed beat
QRS➡️Normal (Narrow)
ST/T wave➡️ ST segment elevations in lead 2 , 3 , AVF , Otherwise are Normal.
QTc/other➡️Normal

◽Diagnosis
👇
This is a Second degree heat block (Mobitz type I ) with Acute inferior STEMI.

◽Presentation
👇
Rate➡️ 100 beat/min
Rhythm➡️irregular
Axis➡️Lt axis deviations
PR/P wave➡️Normal and constant PR intervval , followed by Missed beat in lead 2
QRS➡️M shaped in V1 , V 2
ST/T wave➡️Normal
QTc/other➡️Normal

◽Diagnosis
👇
This is a Second degree heat block (Mobitz type II) with RBBB.

◽Presentation
👇
Rate➡️ 55 beat/min
Rhythm➡️Regular PR , Regular RR intervals
Axis➡️Normal axis
PR/P wave➡️Normal
QRS➡️Wide
ST/T wave➡️Normal
QTc/other➡️Normal

◽Diagnosis
👇
This is a Third (Complete)degree heart block.

ال pdf هذا عبارة عن كيسات محلولة و فيه أغلب ال ECG cases اللي تجي في الإمتحان ، ان شاء الله يفيدكم🌸

أهم مواضيع ال ECG في إمتحان الاورال✋📝✏

STEMI (بأنواعها )
AF
Atrial flutter
SVT(مش شرط تحدد النوع المهم تزبطها )
VT
VF (ما تجيش هلبا)
Torsade de pointes (ما يجيش هلبا)
Heart block (بأنواعه التلاتة)

طبعاً بعد ما تقروا ال ECG و تقولوا ال presentation يسألك بعدها على DX و ال Causes لازم اتبتوهم مهماااات هلباا💡💡

بالنسبة لل TTT ما يسألوش عليها و لو سألوا يبوا إجابة سطحية .

ربي يوفقكم جميعاً.🧡💛