- VT = Ventricular tachycardia
- Afib = Atrial fibrillation
- AVRT = Atrioventricular reentry tachy
- AVNRT= Nodal AVRT
- RBBB = Right bundle branch block
- LBBB = Left bundle branch block
- WPW = Wolff-Parkinson-White syndrome
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This electrocardiogram quiz contains several brief medical histories and their matching ECGs. For each question, you should check between 0 to 4 diagnoses. If the blood pressure is not specified, it means that it is in the normal range.
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Antecedent of myocardial infarction. Pain in the left side of the chest on inspiration. Alcohol intoxicated.
Patient with alcohol dependence. He had some withdrawal symptoms yesterday. Woken in the night with palpitations and inner unrest.
Patient with aortic stenosis. Increasing shortness of breath over the last weeks, waking up with respiratory distress.
Sokolov index 4mV. Left ventricular hypertrophy. Based on this ECG, it is not possible to exclude an anterior STEMI. But check our section on diagnosing STEMI in patients with left ventricular hypertrophy.
Sokolov index 4mV. Left ventricular hypertrophy. Based on this ECG, it is not possible to exclude an anterior STEMI. But check our section on diagnosing STEMI in patients with left ventricular hypertrophy.
Tendency to angina pectoris pain over the last two weeks. The patient has now had 30 minutes of intense chest pain.
Increasing shortness of breath. Known with atrial fibrillation and a personal history of previous stroke.
Central chest pain during most of the day. Since 2 hours ago, severe exacerbation of the pain, radiating now to the jaw and both arms.
Previously healthy. Cardiac arrest successfully reanimated after 5 minutes of CPR. Uncouncious, rattling breathing, BP 60/37mmHg.
Smoker. Two episodes with typical chest pain. The patient goes to his GP and receives nitroglycerin spray with some effect.
Antecedent of AMI/PCI. Increasing shortness of breath and tiredness through the day. BP 192/130mmHg.
Known to have hypertension and being a former smoker. Acute onset of oppressive chest pain that radiates to his jaw.
Previously underwent CABG. An hour ago sudden onset of crushing chest pain radiating to the left shoulder.
Patient seen during a routine visit at his GP. No cardiovascular risk factors. He complains of episodes with pain in the left arm at rest.
Known for many years with a non-malignant palpitation problem. He called the ambulance because he has a episode now. Fine BP.
This ECG does not allow differenciating between VT or AVRT (antidromic WPW)
This ECG does not allow differenciating between VT or AVRT (antidromic WPW)
This patient developed central chest pain radiating to the neck and left arm an hour ago. Associated nausea.
Inferior-posterior-lateral STEMI. ST elevation in II, III, aVF is a classic sign of klasisk STEMI. In addition, the elevation of V5-6 means that there is also a lateral STEMI. ST depression in V1 and V2 is a sign of posterior STEMI (mirror image). An ECG recording in the back (V7, V8, V9 posterior leads) would show ST elevation as well.
Inferior-posterior-lateral STEMI. ST elevation in II, III, aVF is a classic sign of klasisk STEMI. In addition, the elevation of V5-6 means that there is also a lateral STEMI. ST depression in V1 and V2 is a sign of posterior STEMI (mirror image). An ECG recording in the back (V7, V8, V9 posterior leads) would show ST elevation as well.
This patient has diabetes, has an history of previous myocardial infarction and complains of dyspnea and chills. Temperature 39°C
Antecedent of myocardial infarction. Increasing shortness of breath with frothy pink sputum over 2 days. Hypoxemia.
Known with atrial fibrillation, hypertension and aortic stenosis. Debut 10 hours ago with gradual onset upper abdominal pain that spreads gradually to the thorax and described as a constant oppressive sensation radiating to the neck. BT 160/76
Wakes up with chest pain radiating to the neck and jaw. The pain does not depend on breathing or position.
Known with diabetes, ischemic heart disease and COPD. Increasing shortness of breath. Known with daily intermittent chest pain.
Known with ischemic heart disease, atrial fibrillation and pacemaker. This afternoon onset of malaise, coughing, chest pain localized in the left side and neck pain. A bit of dyspnea as well.
This ECG is very pathological. An anterior STEMI can be suspected (check our section on diagnosing STEMI in patients with left ventricular hypertrophy) but significant ST depression in 6 leads associated with ST elevation in aVR is suspect for left main stenosi. Although this criterion is not specific. This patient did have left main stenosis and got a CABG.
This ECG is very pathological. An anterior STEMI can be suspected (check our section on diagnosing STEMI in patients with left ventricular hypertrophy) but significant ST depression in 6 leads associated with ST elevation in aVR is suspect for left main stenosi. Although this criterion is not specific. This patient did have left main stenosis and got a CABG.
ST depression in II, III, aVF, V4-6. Non-significant ST elevation V1, V2, aVR, aVL. Hyperacute T waves V2-3. This patient had a closed proximal LAD.
ST depression in II, III, aVF, V4-6. Non-significant ST elevation V1, V2, aVR, aVL. Hyperacute T waves V2-3. This patient had a closed proximal LAD.
Shortness of breath throughout the night, woke up several times. Accompanying mild left sided oppressive chest pain.