ECG.CASES
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Daily ECG

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The correct answer is “Second degree AVB: mobitz 1 (Wenckebach)”
ECG features:
• QRS complexes cluster into groups, separated by short pauses. At the end of each group is a non-conducted P wave (dropped beats)
• The PR interval progressively increases from one complex to the next.
• The P-P interval is relatively constant despite the irregularity of the QRS complexes.
65 y female with history of heart failure presented with palpitation
The correct answer is “Atrioventricular nodal reentry tachycardia (AVNRT)”
In the beginning, there are sinus beats that are conducted with 1st degree AV block. These beats are followed by ectopic atrial contractions which are not conducted through AV node (blocked PACs). However, an ectopic atrial contraction eventually triggers an AVNRT, a regular narrow complex tachycardia with relatively long RP intervals due to slow conduction through retrograde pathway in the AV node.

Special Thanks to my dear friend salvatore salvatore for providing the diagram.
#case199 ❤️
55 y female with history hypothyroidism presented with palpitation and lightheadedness.
What is the most likely diagnosis based on the ECG findings?
Anonymous Poll
26%
AVNRT (PSVT)
54%
Atrial flutter
11%
Atrial tachycardia
9%
Atrial fibrillation
The correct answer is “Atrial flutter”
ECG features:
• Narrow complex tachycardia at ~160 bpm.
• Sawtooth flutter waves are seen best in the inferior leads (II, III, and aVF)
• There is a clear 2:1 relationship between the flutter waves (~320 bpm) and QRS complexes (~160 bpm).
#case200 ❤️
75 year old man with 2 hours chest pain.