Stuart A. Winston, D.O.
Michael H. Lehmann, M.D.
Richard D. Judge, M.D.

Case Index
 
Link
Level
Description
Week01
Basic
This is a routine preoperative ECG taken on a 66 year old woman scheduled for cataract surgery. She denies all
cardiovascular symptoms.
Week02
Questions
Basic
59 yr old man with HTN, CAD and bypass surgery 2 years earlier, complicated by post-operative atrial fibrillation. Presents now with palpitations and pre-syncope.
Week03
Questions
Intermediate
69 year old man with substernal chest discomfort. BP 70 mm Hg. History of HTN.
Week04
Questions
Basic
A 57 yr old woman is seen urgently for chest pain of two hours duration. The pain is mild, continuous, aching and localized to the left upper chest and shoulder. No previous cardiovascular problems.
Week05
Questions
Advanced
A 75 year old woman is seen in the emergency room because of progressive dyspnea over a period of three days. Her examination confirms the presence of congestive heart failure with bilateral crackles, elevated jugular venous pressure and bilateral 1+ edema.
Week06
Questions
Intermediate
46 year old man with right shoulder pain
and dyspnea. History of alcoholism. No prior cardiopulmonary disease history.
Week07
Questions
Intermediate
A previously healthy 67 year old carpenter with dyspnea and chest pressure of 24 hours duration.
Week08
Questions
Intermediate
81 year old woman presents with
substernal chest pain. History of hyperlipidemia. She had a narrow QRS on an ECG in 1987.
Week09
Questions
Intermediate
56 year old woman undergoing chemotherapy for bronchio-alveolar carcinoma. Two years previous underwent emergency pericardiocentesis for cardiac tamponade (malignant effusion). Complaining of rapid palpitations.
Week10
Questions
Intermediate
59 year old man with a 9 year history of palpitations. Had a recent syncopal episode.
Week11
Questions
Basic
51 yr old male with no prior cardiac history presents with mid-sternal chest discomfort.

On Monday of each week at this site there will appear a new 12-lead electrocardiogram (ECG). Accompanying the ECG will be a clinical vignette relevant to the tracing and one or two questions for you to answer.

The tracings will be classified by their interpretive difficulty:

Basic: The ECG represents a basic clinical problem or basic ECG principle. Should be mastered by a graduating medical student.

Intermediate: The ECG presents a more challenging or complex problem. Should be able to be mastered by most graduating Family Practice, Medicine or Emergency Medicine residents.

Advanced: Presents a complex, subtle or advanced ECG concept. Physicians with a special interest in ECG’s or Cardiology fellows should find these tracings interesting.

Further clinical follow-up information will often be offered to cement the electrocardiographic concept.

 

Address questions about the ECG’s by E-mail to:

Dr. Winston swinston@michiganheart.com

(send to both addresses for a more prompt response)

Dr. Judge rjudge@umich.edu

Dr. Lehmann lehmann@umich.edu