Wednesday, October 13, 2010

Interesting ECG (5)

You were asked to examine this gentleman's cardiovascular system. By only inspection, you should have gathered two possible diagnoses in mind.

Got it? If not, then have a look at the ECG (not his but just to give you a hint):

(ECG from askdrwiki.com)

Now shout out the answer! ;)

11 comments:

shay said...

dextrocardia

Darren Lee said...

What did the pic show? :)

shay said...

may i know whether my answer is correct?

Anonymous said...

ECG mark?

shay said...

Try again:

Dextrocardia , possibility with Kartagener's syndrome.

pilocarpine said...

1: small circular, erythema, non-elevated lesion around the right nipple at 3,5,7 o'clock at position where chest leads would be if it was at left chest

2: right axis deviation and loss of voltage across the precordium. There are also inverted p waves in leads I and aVL

dx.
1. dextrocardia
2. temporary erythema due to suction (unlikely sensitivity to gel/lead as only 3 reddish mark instead of 6.

2nd question:
how will u proceed, darren?

Darren Lee said...

Ha ya this is actually a very straightforward one:

Pic is showing electrode leads mark - but of a right-sided one. If you get such case in exam, you already know that it's dextrocardia before you examine. The other circumstance that we do right-sided ECG is to look for RV infarct in Inferior MI - unlikely to come out in exam.

ECG shows what we called "Reverse R progression" - a feature of Dextrocardia.

Then you should proceed to palpate for side of liver - look for situs inversus, and auscultate the lung bases for crepitation - bronchiectasis in Kartagener's syndrome.

Shay said...

Sorry for my rudeness.

Thanks for sharing, Dr Lee!

pilocarpine said...

thanx4d cme...

Darren Lee said...

Shay: Welcome!;)

Pilocarpine: Not at all..just sharing. Glad that you participated ha ;D

Sarah said...

yay~ got it rite, even tho this is an old post. :)) the pic of the chest was unclear, cuz it looked like rashes but the ECG is awesome~ thanks!!

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