SAQ 958 – Cardiology – palpitations, presyncope and serial ECG interpretation

A 78-year-old woman presents with 24 hours of exercise-induced self-limiting chest pain, intermittent palpitations and one episode of presyncope.

She has no significant medical history, takes no regular medications and is currently pain-free. Her observations are temperature 37 degrees C, pulse 160/min, BP 168/100 mmHg, RR 20/min and SaO2 95% on room air.

Initial ECG, rhythm strip and repeat ECG are shown below.

List four relevant findings on the initial ECG.

(Marked out of 4.0)

/ 4

List four initial treatment options and give a brief rationale for each.

(Marked out of 4.0)
</p> <table class="saq-prop-table" style="width: 100%; max-width: 100%; table-layout: fixed; border-collapse: collapse;"> <thead> <tr> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Treatment option</th> <th style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Rationale</th> </tr> </thead> <tbody> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Option 1</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Option 2</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Option 3</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> <tr> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;">Option 4</td> <td style="overflow-wrap: anywhere; word-break: normal; white-space: normal; vertical-align: top; box-sizing: border-box;"></td> </tr> </tbody> </table> <p>

/ 4

She becomes faint, pale and diaphoretic with pulse 180/min, BP 100/70 mmHg, RR 30/min and SaO2 95% on room air. Name the rhythm on the monitoring strip and list three possible treatment steps.

(Marked out of 4.0)

/ 4

After treatment her haemodynamics improve. List three relevant findings on the repeat ECG.

(Marked out of 3.0)

/ 3

List three possible causes for the repeat ECG appearance.

(Marked out of 3.0)

/ 3

Total Score: 0 / 18

Percentage: 0%