ECGs

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?

A 70-year-old man, who had had angina for several years, began to complain of attacks of dizziness. This is his ECG. What does it show and what would you do?

A 50-year-old man, who had complained of attacks of dizziness and palpitations for several years, collapsed at work and was brought to the A & E department. What's your interpretation and diagnosis?

This ECG was recorded from a 60-year-old man with no symptoms, who wanted a private pilot’s licence. Is the ECG normal?

A 50-year-old man was admitted to hospital as an emergency with chest pain; he was not aware of a rapid heart rate. Shortly after this ECG was recorded, his heart rate suddenly slowed and his ECG was then normal.

This is the ECG from a 25-year-old man who complained of episodes of fast, regular, palpitations associated with breathlessness and dizziness. There were no abnormalities on examination other than a slow and irregular pulse. What is the diagnosis and how can his problem be treated?

A 70-year-old woman, admitted to hospital because of increasing heart failure of uncertain cause, collapsed and was found to have a very rapid pulse and a low blood pressure. This is her ECG. She recovered spontaneously. What is this rhythm, and what would you do?