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  • ECG #9 RVH with or without?

    ECG #9 RVH with or without?

    We saw 2 patients yesterday that both had significant RVH One had chest pain, the other had COPD exacerbation. Can you pick which one had the ischaemia?                       See the ECG#8 here for an infarct hiding in LBBB    

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  • ECG #8  More chest pain!

    ECG #8 More chest pain!

    A 65 yo Male comes in with central chest pain of 1 hour duration What is the diagnosis and what criteria did you use to confirm?  

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  • Takutswhat??


    A case which is a classic presentation of a rare condition – or is it?

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  • Be a clinical detective in a minute!!

    Be a clinical detective in a minute!!

    Watch the signs unfold and see if you can diagnose this common condition

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  • A terrible case of tropical fever

    A terrible case of tropical fever

    Hi everyone, another important and very tragic case from Sri Lanka An adolescent  comes in with fever, abdo pain, vomiting, lethargy and malaise. He had been sick for about 7 days and had been at the local hospital 80 km away for 24 hrs. On presentation he had a BP of 58/25 and a pulse of 65. He had a tender abdomen which was mildly distended a few cervical and inguinal lymph nodes and bibasal crackles. He was given NS resuscitation […]

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  • A curious tachycardia

    A curious tachycardia

    This is a case from Galle, Sri Lanka which shows a very unusual case of a 32 yo lady 3 days post partum who presents with palpitations. What’s unusual is that she can transmit AF and flutter at 1:1 to her ventricles…implying an abnormal connection to her ventricle, not her AV node. Usually a WPW Accessory pathway will lead to at least a few broad complexes as the pre-excitation leads to early ventricular depolarisation and a delta wave /broad complex. […]

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    The ECG in toxicology. Cardiac electrophysiology is used to explain how to use the ECG to decide which poison your OD patient has taken, and how to guide treatment.

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    This tutorial is a mix of various wide complex tachycardias in case based format. It explains some of the major wide fast and scary rhythms and how to differentiate and manage them.

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    A 81 yo old lady presents feeling decidedly crook. She feels wobbly on her pins and has fallen over a few times in the least 3 days – thankfully on carpet and she’s uninjured. Her ECG is done and appears below   1. What is the diagnosis? 2. What is your stepwise management assuming the BP is 80/40

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  • ECG week 6 syncope ANSWER

    ECG week 6 syncope ANSWER

              So this ECG is sinus rhythm and has broad complexes with RSR’ in V1 V2 consistent with RBBB. the PR interval is over 200ms (1 big square) so there is a first degree AV block as well. There is also a left axis deviation (V1 up aVF down). In the setting of RBBB and Left axis you should think about left anterior or posterior hemi/fascicular block  (LAFB, LPFB). There are rS complexes in II, III, […]

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