This is one of the serial ECGs on a 66 year old man who presented to ED following post-coital exertion. He has a history of multiple myeloma diagnosed 5 years ago and receives 4 weekly cycles of Carfilzomib/Dexamethasone therapy but has no other medical history. On the mention of having a heart attack, the patient states he does not want to be resuscitated. Please interpret the ECG and lists your next steps in the management of this patient.
ECG of the Week 21st December 2022 – Interpretation
This ECG was obtained from a 22 year old man who had taken a polypharmacy overdose 24 hours ago. He had suffered a bradycardic / asystolic arrest and is currently in the intensive care unit. At the time of this ECG being printed, the patient is off all medical therapy directed towards chronotropy / inotropy. Please describe and interpret the ECG and outline your next steps to continue safely managing this patient.
The following ECG was obtained in a 38 year old Indigenous man with a history of ischaemic cardiomyopathy at a regional hospital. He did not have a history of left bundle branch block previously. Please describe and interpret the ECG.
ECG of the week 7th December 2022 – Interpretation:
Paramedics ring through to say that they are 10 minutes away with a 65 year old man who has a heart rate of approximately 170 with a thready pulse and a systolic blood pressure of 90. This is the first ECG obtained. Please interpret the ECG and describe how you will manage the patient.
The following ECG was obtained from an independent 78 year old woman at 11pm who complained of left sided shooting jaw ache that had commenced earlier that morning. She is adamant she has no chest pain. She had taken a RAT test earlier in the morning because of myalgia and was day 1 COVID positive.
The most obvious abnormality is ST segment elevation in lead aVR with diffuse ST depression in most other leads (least in aVL but obvious in all others).
A 60 year old man, who speaks little English, is triaged as a category 2 for left sided chest pain after being brought to hospital by ambulance. He has a history of the following:
- CMML under surveillance (he says “no treatment, just blood tests”, but can’t tell you who his haematologist is)
- Kidney Dysfunction (he can’t elaborate further)
- Hypercholesterolaemia (takes a statin)
- Reflux (takes a PPI)
A 55 year old male presents to ED feeling unwell. Below is the patients ECG: