Abstrait

Interesting ECG cases – unveiling the diagnosis

Praveen Nagula

 Electrocardiogram (ECG) is an essential tool of investigation in the evaluation of cardiac patients. We describe four interesting ECG cases. Case 1: The atrioventricular reentrant tachycardia (AVNRT) is usually associated with no structural heart disease. It being manifested at the initial presentation of Anomalous left coronary artery from the pulmonary artery (ALCAPA) in a young adult male is rare. Case 2: Atrial fibrillation with complete heart block is relatively rare in a patient with amyloidosis. We had a case of recurrent pericardial tamponade, which was diagnosed as cardiac amyloidosis on cardiac MRI. Case 3: The ECG helps to differentiate the subsets of acute coronary syndrome. Sometimes, there can be misinterpretation of the culprit artery due to physical errors i.e., the lead misplacement. Case 4: The accessory pathways usually have a refractory period less than the atrioventricular node. The most common manifestation is Atrioventricular reentrant tachycardia (AVRT) due to orthodromic conduction through the accessory pathwayWe had a case post prosthetic mitral valve replacement presenting with acute heart failure. The ECG at presentation showed typical atrial flutter with 2:1 conduction. On giving IV calcium channel blocker, there was sinus rhythm with short PR interval and a delta wave suggestive of the right posteroseptal pathway.