- 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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Patient with a biologic aortic valve and atrial fibrillation. Takes dronedarone. Suddent onset of palpitation, as well as chest pain and nausea.
Orthodromic AVRT (retrograd P-wave > 70 ms after QRS, see V1) most likely. Global repolarisation abnormities that does not fullfill STEMI criteria. The tachycardia should be acutely terminated and patient symptoms and ECG should be reevaluated for possible ischemia.
Orthodromic AVRT (retrograd P-wave > 70 ms after QRS, see V1) most likely. Global repolarisation abnormities that does not fullfill STEMI criteria. The tachycardia should be acutely terminated and patient symptoms and ECG should be reevaluated for possible ischemia.
Suddent onset of shortness of breath and chest pain, which started a few hours ago during a badminton game.
Cardiac arrest preceded by central retrosternal chest pain radiating the the left arm. Succesful CPR, awake and responding.
Diabetic known with hypertension and hypercholesterolemia. Sudden onset of severe chest pain 5 hours ago.
Had severe angina that started 5 days ago and lasted for 2-3 days. Now suddenly hemoptysis, severe dyspnea, hypoxemia….
Patient with dilated cadiomyopathy. Felt sick and sweating abnormally after exercising. Near syncope. Kendt DCM.
History of prior CABG. Known with left bundle branch block. 3 days with shortness of breath, cough and fever. Normal BP.
Patient followed for aotic valve stenosis, is awaiting CABG + valve operation. Acute, central, opressive chest pain which started 3 hours ago. BP 70/40mmHg.
Although this ECG does not fullfil the criteria for STEMI, this patient history is very worrying and an evaluation in an hospital with a cardiothoracic surgery department should be undertaken.
Although this ECG does not fullfil the criteria for STEMI, this patient history is very worrying and an evaluation in an hospital with a cardiothoracic surgery department should be undertaken.
History of prior PCI of LAD. Patient is diabetic and has hypercholesterolemia. 1-2 hours with pain on the left side of the chest radiating to the left arm pit.
Accelerated idioventricular rhythm with fusion and capture at the end of the ECG. Anterior and inferior ST elevation. The ST segment cannot be interpretated in presence of an idioventricular rhythm. Accelerated idioventricular rhythm is defined with a frequence between 50 and 110 bpm and is seen when ventricular activity superseeds sinus node activity. This rhythm is typically seen under ischemia/reperfusion and digitalis intoxication.
Accelerated idioventricular rhythm with fusion and capture at the end of the ECG. Anterior and inferior ST elevation. The ST segment cannot be interpretated in presence of an idioventricular rhythm. Accelerated idioventricular rhythm is defined with a frequence between 50 and 110 bpm and is seen when ventricular activity superseeds sinus node activity. This rhythm is typically seen under ischemia/reperfusion and digitalis intoxication.
Wakes up in the middle of the night with increasing shortness of breath. At the end has also mild chest opression.
Patient with a history of atrial fibrillation and ischemic heart disease. 2 days with chest pain, shortness of breath and palpitation.
Patient with ischemic heart disease. Increasing shortness of breath in a few days. Wakes up with exacerbation of his dyspnea. 3 syncopes.
Just discharged from hospital after a syncope of unknown origin. Now twitching and malaise. No angina, no dyspnea.
Woke up with central oppressive chest pain which are increase with deep inspiration and when lying on the back.
Cardiac arrest after a period of shortness of breath and general malaise. Now open eyes and moves his extremities.
Increasing pain between the scapula since yesterday, radiating in both arms, but especially the left one.
Dement alcoholic with many cardiovascular risk factors, who complains of intemittent chest pain. Now pain free.
Several episodes of violent chest pain during the last 3 days. 2 episodes today associated with loss of consiousness.
75 years old patient with hypertension and diabetes. Has chest pain which started an hour ago. BP 185/120mmHg. Improving after NTG spray.
CABG in 2003. Chest pain since yesterday. The pain is aggravating after he had been working with a showel in the snow.
Smoker but otherwise healthy patient with constant chest pain since yesterday evening. Meets at his GP. He is feeling really bad and has colds sweats. Normal BP.
Inferior Q wave , almost significant ST elevation inferior (<1mm)
Inferior Q wave , almost significant ST elevation inferior (<1mm)
This patient has potential indication for pacemaker implantation.
This patient has potential indication for pacemaker implantation.
Know with an undefined heart disease. Central oppressive chest pain during the past two weeks. This night malaise and dizziness.
Right bundle branch block + strain. This patient had a plumonary embolism.
Right bundle branch block + strain. This patient had a plumonary embolism.
This patient had nausea when he woke up this morning but he has now severe chest pain which started an hour ago.
History of previous AMI/PCI. Oppressive chest pain radiating to both arms which started 4 hours ago.
Young patient with one hour of palpitation, mild chest oppression and discrete shortness of breath and dizziness. Has had several similar episodes among the last few years.