Interesting EKG Challenge

الكاتب : Voice-of-reason   المشاهدات : 634   الردود : 5    ‏2007-09-06
      مشاركة رقم : 1    ‏2007-09-06
  1. Voice-of-reason

    Voice-of-reason عضو

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    This a 64-year-old man presented with progressive shortness of breath and exercise intolerance due to end-stage ischemic
    cardiomyopathy
    (I apologize for the small Pic if someone know how to make it bigger or needed by email let me know)

    What is the Diagnosis

    1. Digitalis intoxication
    2. Dextrocardia
    3. Pacemaker malfunction
    4. Electrical alternans
    5. Cardiac allograft
     
  2.   مشاركة رقم : 2    ‏2007-09-07
  3. الرهينه

    الرهينه قلم ذهبي

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    الصوره صغيره جدا جدا

    لكن الملاحظ وجود electric signal قبل كل QRS ليست الP wave ..

    اعتقد ان الاجابه هي

    pacemaker malfunction
     
  4.   مشاركة رقم : 3    ‏2007-09-07
  5. Voice-of-reason

    Voice-of-reason عضو

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    ‏2007-09-05
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    Excellent observation(الرهينة)...
    that was my first impression on this EKG,

    but unfortunately that is not the answer,
    I'll have the answer up in a couple days and
    I'll try to load some more images -CT and X-ray

    شكراً ..
     
  6.   مشاركة رقم : 4    ‏2007-09-07
  7. Voice-of-reason

    Voice-of-reason عضو

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  8.   مشاركة رقم : 5    ‏2007-09-08
  9. الرهينه

    الرهينه قلم ذهبي

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    from the CT picture and Xray

    there`s another heart in the chest

    is that heart transplanted and the original one is left in place to get more blood without working in order to replanted again after many years ,,, i heared about something like this done by the cardio-surgeon prof Ya`aqoub in england :)
     
  10.   مشاركة رقم : 6    ‏2007-09-08
  11. Voice-of-reason

    Voice-of-reason عضو

    التسجيل :
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    Yes!! there are two hearts the original heart was left in place becasue of pulmonary HTN, so that native heart maintains right sided circulation inspite of the PHTN, anyhow Execellent JOB

    The EKG findings are as follow:
    IF you look carefully at the leads you have two different QRS with different Axis and that is because the transplant heart is on the right side of the thorax.

    Thanx
     

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