ECGs

A 25-year-old woman, who had had episodes of what sound like a paroxysmal tachycardia for 10 years, produced this ECG when seen during an attack. What is the rhythm, and what is the underlying problem?

This ECG was recorded from a 60-year-old man admitted to hospital with severe heart failure and a heart murmur. What does it show and what would you do?

A 70-year-old man, who has had angina for 10 years, is admitted to hospital with severe central chest pain that has been present for 4 h. This is his ECG. What does it show and what would you do?

This ECG was recorded from a 15-year-old boy who collapsed while playing football, but was well by the time he was seen. What are the possible diagnoses?

An 85-year-old man, who has had high blood pressure for many years, is seen in the outpatient department complaining of typical angina and of occasional dizziness when walking up hills. What is the diagnosis, and what would you do?

A 30-year-old man, who had had attacks of palpitations for several years, was seen during an attack, and this ECG was recorded. He was breathless and his blood pressure was unrecordable.

An 18-year-old student complains of occasional attacks of palpitations. These start suddenly without provocation; the heartbeat seems regular and is ‘too fast to count’.

This ECG was recorded from a 30-year-old woman with severe rheumatoid arthritis, who was admitted to hospital with central chest pain. She was a non-smoker and had no risk factors for coronary artery disease. What do you think is going on?

A 70-year-old man is sent to the outpatient department because of attacks of dizziness. What abnormalities does his ECG show, and what treatment is needed?

A 60-year-old man who complains of ankle swelling is found to have an irregular pulse, a blood pressure of 115/70, an enlarged heart, and signs of congestive cardiac failure. What does the ECG show? He is untreated – how would you manage him?