Rhythm Puzzle

نویسندگان

  • A. Erol-Yilmaz
  • S. Westra
  • J. L. R. M. Smeets
چکیده

A 78-year-old man presents with dizziness for 3 days. This lasts for 30 s to 1 min; he does not feel palpitations and has no other cardiac symptoms. Nine years ago, he was analysed for chest pain; exercise testing and echocardiography were normal. His further medical history reveals depression and hemi-colectomy because of colon carcinoma. Current medication consists of aspirin, lisinopril, simvastatin, lithium carbonate, nortrilen, pantozol, alprazolam and movicolon. Physical examination revealed a slow regular pulse of 40 beats/min with a blood pressure of 110/60 mmHg, and investigation of heart and lungs was within normal limits. The ECG on admission is shown in Fig. 1. Laboratory examination showed a normal blood level of lithium and nortrilen. The echocardiography showed normal left ventricular function with a mild aortic stenosis. What is your interpretation of the ECG? ■ Answer You will find the answer elsewhere in this issue.

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عنوان ژورنال:

دوره 19  شماره 

صفحات  -

تاریخ انتشار 2011