49 year old male with history of intermittent palpitations interpreted by GP as atrial fibrillation/flutter, severe sleep apnoea (refuses to use continuous positive airway pressure machine) and dilated cardiomyopathy (of possible alcohol or tachyarrhythmia origin) with a recent ejection fraction of around 40-45% calls the ambulance after waking with severe palpitations and shortness of breath. He explains he has had the same palpitations wake him once or twice a week for the last month but they only ever last a few minutes. After his Temazepam ran out the night before the man had trouble getting to sleep that night and when his sleep was disturbed by the intense palpitations it took an hour of symptoms before his wife found him and called an ambulance.
State ambulance service arrives to see the man pacing the room attempting to breath deeply while his wife encourages him to relax.
This ECG is recorded:
The man is in mild distress, has a strong palpable pulse, tachypnoeic at 38 breaths a minute and his manual blood pressure initially reads 215/119 mmHg.
Analise this ECG: Rate, rhythm, P waves, QRS, ischaemia...etc
What are the
differential diagnoses?
What is the most likely scenario based diagnosis? and how about the electrocardiographical signs?
Will update soon...
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