ECGs

A 55-year-old man with a severe nonischemic cardiomyopathy is treated with furosemide, carvedilol, lisinopril, and spironolactone. One month after starting therapy, he feels very tired and weak

A 35-year-old man presents to his community emergency department with complaints of a racing heart. Symptoms began that evening while he was watching television and have persisted since.

An 88-year-old woman is brought to the emergency department because of fever to 104°F associated with shaking chills. Evaluation showed a WBC count of 24,000 and evidence of pyelonephritis. She has history of chronic renal insufficiency.

A 56-year-old woman presents to her primary doctor as an urgent care visit. She has had palpitations and chest pressure for several hours since waking. Her radial pulse is rapid and her JVP is elevated. Her lungs are clear. An ECG is obtained.

A 68-year-old man with end stage renal disease is seen at his hemodialysis center. He missed his last scheduled hemodialysis session.

A 64-year-old woman presents to her internist because of diffuse bone pain, fatigue, and a 20-pound weight loss. Routine blood tests showed a hematocrit of 25, a serum creatinine of 2 mg/dL.

A 74-year-old man on digoxin for rate control of paroxysmal atrial fibrillation is admitted with pre-syncope.

A 64-year-old woman with longstanding diabetes is evaluated for complaints of atypical chest discomfort (left-sided ache). She has been taking a β-blocker for hypertension. She undergoes an exercise stress test, which provokes her symptoms.

A 56-year-old diabetic man with no known heart disease presents with near-syncope. His blood pressure is 100/60 mm Hg, and he is diaphoretic.

A 57-year-old woman presents to the emergency department with symptoms of chest pressure at rest, lasting for about 1 hour. She has a history of left main coronary artery stenosis as well as three-vessel disease for which she underwent bypass surgery 4 years ago.