dm cardiology exam spotter
TRANSCRIPT
Spotters
DR PRAVEEN GUPTA
Moderator
DR Raja Selvaraj
Departement of Cardiology
JIPMER
Pondicherry, India
Date -29/02/2016
Spotter-1
20 years old female present to the JIPMER female cardiology OPD with
History of 8 months amenorrhea
Palpitation on and off since 1 month
Description of the ECG
Narrow complex regular
tachycardia
Heart rate=188/min
Normal axis
PR interval 120 msec
RP intrval 160 msec
P wave postive in lead 2,3,avf
Negative in Lead V1,V2
RP interval longer than PR interval
ECG diagnosis
Long RP tachycardia
Differential diagnosis
Atrial tachycarida
Atypical AVNRT
PJRT
Approach to a patient with narrow QRS tachycardia
Spotter-2
45 Years old female present to the JIPMER female OPD with history of
Recurrent palpitation since 2 months
Description of the ECG
NSR
69/min
PR interval 84 msec
Delta waves Negative in V1
Delta waves are Negative in lead II, III, avf
Diagnosis
WPW syndrome with Right Posteroseptal pathway
Approach to a patient with WPW syndrome
Spotter-3
55 year old male present to the JIPMER causality with one day history of
Palpitation
Chest pain
Dyspnoea
Description of the ECG
Narrow complex tachycardia
Rate 190/min
Negative P wave in lead II,III,
Avf
RP interval 120 msec
PR interval 240 msec
Diagnosis
Short RP interval narrow QRS
tachycardia
Differential Diagnosis
AVRT
AVNRT
Spotter-4
55 years old male present to the JIPMER cardiology emergency with 2
hours histroy of
Palpitation
Dyspnoea
Chest pain
ECHO-Structrually normal heart
Description of the ECG
Broad complex regular
tachycardia
HR=190/min
QRS duration200 msec
Infeior axis
LBBB morphology
Capture beat
Fusion beat
Differential diagnosis
RVOT VT
ARVD
Approach to a patient with Outflow tract VT in normal heart
Outflow tract VT
In structurally normal hearts
Manifest as premature ventricular complexes (PVCs), salvos of VT, and
sustained VT
Exercise or emotional stress trigger VT
Prognosis favorable
Verapamil effective therapy
Catheter ablation very effective
Spotter-5
A 30 year old male present to the JIPMER cardiology OPD with chief
complaints of
Dyspnoea on exertion since childhood
Cyanosis since 1 year
Chest X-ray of patient done
Chest X-ray
Description of the chest X-ray
Chest X-ray s/o Dilated main pulmonary artery with dilated left and right
pulmonary artery
Decrease pulmonary vascularity
Dilated Right atrium, right ventricle
Diagnosis
Eisenmenger syndrome in a patient with atrial septal defects
Spotter-6
Description of Ventriculogram
RV ventriculogram shows reduced movement in the tricuspid and inferior
wall regions
Localized akinetic or dyskinetic bulges, outpouchings, dilatation of the
infundibulum, trabecular hypertrophy, and/or disarray with deep fissures
Diagnosis-ARVD
Spotter-7
Description of the Cath Study
Percutaneous Aortic Valve Replacement for Severe Aortic Stenosis
Balloon valvuloplasty with a 20- to 23-mm balloon under rapid pacing was
performed before device placement, after which over a stiff guidewire,
placed in the left ventricle, the device was deployed retrogradely under
fluoroscopic guidance
Spotter-8Identify the foreign object in the Chest X-ray
Nanostim (Leadless Pacemaker)
St Jude Medical, introduce leadless pacemaker
Resides entirely in the right ventricle
No leads
No chest incision
No scar
No permanent lump under the skin
Spotter-9Identify the foreign object in the Chest X-ray
Subcutaneous ICD
Novel defibrillator
Defibrillation lead completely outside the chest cavity
Terminate life-threatening arrthythmias
