ECG Test – Mixed Conditions – The Cardiovascular

Male 58 years with chest pain.

Identify all abnormalities on the ECG.

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Sinus rhythm

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Acute inferolateral myocardial infarction (STEMI)

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Posterior acute myocardial infarction

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ST-segment depressions in V1–V3 are reciprocal (mirror) posterior ST elevations.

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Persistent ST elevations strongly suggest there is myocardium that can be salvaged by means of revascularization.

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Sinus tachycardia

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A 64 year old male patient with hypertension. ECG is recorded during his annual health screening. He is asymptomatic during the recording. Heart rate 67 beats per minute. Identify all abnormalities on the ECG.

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AV block 1

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ST depressions in lateral leads (V5, V6, aVL, I), possibly due to left ventricular hypertrophy secondary to hypertension.

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ST depressions in lateral leads (V5, V6, aVL, I), possibly due to ongoing myocardial ischemia.

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Normal AV conduction

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Sinus rhythm

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A 42-year-old male with obesity. Reports increasing dyspnea over the past month.

Identify all abnormalities on the ECG.

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Sinus rhythm

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Sinus tachycardia

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Low voltage in precordial (chest) leads

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Low voltage in limb leads

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Pathological Q waves in inferior leads (II, aVF, III)

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A 68-year-old male with type 2 diabetes.

Identify all abnormalities on the ECG.

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Heart rate is roughly 75 beats per minute (300/4=75)

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Heart rate is roughly 100 beats per minute (300/3=100)

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Low voltage in chest leads

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Normal voltage in chest leads

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Low voltage in limb leads

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Normal voltage in limb leads

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Fragmented QRS complexes in inferior limb leads (II, aVF, III)

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Inferior leads show small r-waves followed by large S-wave. These could be the normalization of old Q-waves (with the resurgence of a small r-wave)

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Inferior Q-wave infarction (pathological Q-waves in II, aVF, III)

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A 79-year-old male. No other data.

Identify all abnormalities on the ECG.

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Left axis deviation

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Right axis deviation

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Normal heart axis

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Generally low voltage

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Acceptable voltage

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A 75-year-old male. No other data.

Identify all abnormalities on the ECG.

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Sinus rhythm

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Left axis deviation

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Normal heart axis

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Poor R-wave progression in V1-V6

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AV block 1

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QRS duration >120 ms; non-specific intraventricular conduction delay (IVCD)

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Normal QRS duration

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Left bundle branch block

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Right bundle branch block

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A 62-year-old male with chest discomfort.

Are there signs of acute (ongoing) myocardial ischemia?

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There are no signs of ischemia.

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There are definitive signs of ischemia.

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There are changes suggestive of ischemia.

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A 32-year-old male is in the ED. He had COVID-19 in December 2020, and has experienced pleuritic chest pain since the infection. Your colleague suggests his ECG shows acute perimyocarditis.

Are there signs of acute perimyocarditis? Are the precordial T-waves within normal limits?

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T-waves are within normal limits.

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T-waves are not within normal limits.

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There are signs of acute perimyocarditis.

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There are no signs of acute perimyocarditis.

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A 35-year-old female athlete with a history of syncope during exercise.

Your initial assessment concludes that the ECG is normal, but your colleague warns you that lead V1 may reveal an ongoing atrial flutter. Is that correct?

No, there are no signs of atrial flutter.

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Yes, this ECH shows atrial flutter with normal ventricular rate.

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ECG recorded in a 60-year old male. The rhythm is sinus rhythm, but the morphology is clearly abnormal. Which conditions are consistent with this ECG?

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Acute myocardial ischemia

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Left ventricular hypertrophy

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Apical hypertrophic (obstructive) cardiomyopathy

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ECG Tests (Quiz)

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ECG Test – Mixed Conditions

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