Self Assessment Quiz

Question 1
A 77 year old female complains of epigastric pain and dizziness. What does the rhythm strip reveal (Lead II)?

II

Question 2
An 88 year old man presents with recurrent episodes of dizziness. What is the ECG diagnosis?

I aVR V1 V4

II aVL V2 V5

III aVF V3 V6

Question 3
A 17 year old woman complains of palpitations and dizziness. What is the ECG diagnosis?

II

85
86 ABC of Clinical Electrocardiography

Question 4
What is the diagnosis?
TRIP 20

II

Question 5
A 35 year old man presents with chest pain. What is the ECG diagnosis?

I aVR V1 V4

II aVL V2 V5

III aVF V3 V6

Question 6
What is the ECG diagnosis?

I aVR V1 V4

II aVL V2 V5

III aVF V3 V6
 Self Assessment Quiz 87

Question 7
What is the ECG diagnosis?

Question 8
What is the ECG diagnosis?
I aVR V1 V4

II aVL V2 V5

III aVF V3 V6

Question 9
What is the rhythm?
I aVR V1 V4

II aVL V2 V5

III aVF V3 V6

II
88 ABC of Clinical Electrocardiography

Question 10
An 80 year old man presents with nausea and dizziness. What is the ECG diagnosis?

Question 11
What is the rhythm?

II

Question 12
What is the rhythm?

Question 13
What is the rhythm?

Question 14
An elderly female is found on the floor with a fractured hip. What is the ECG diagnosis?

I aVR V1 V4

II aVL V2 V5

IIII aVF V3 V6
 Self Assessment Quiz 89

Question 15
A young woman complains of recurrent palpitations. What is the ECG diagnosis?

II

Question 16
A 63 year old man complains of atypical chest pain. What is the diagnosis?
I aVR V1 V4

II aVI V2 V5

III aVF V3 V6

Question 17
A 93 year old woman presents with shortness of breadth. What is the ECG diagnosis?

Question 18
A 40 year old man presents with chest pain. What is the ECG diagnosis?

I aVR V1 V4

II aVL V2 V5

III aVF V3 V6
90 ABC of Clinical Electrocardiography

Question 19
A 38 year old man has been feeling generally unwell for several weeks. What is the ECG diagnosis?
I aVR V1 V4

II aVL V2 V5

III aVF V3 V6

Question 20
An elderly man presents in a collapsed state. What is the rhythm?

Question 21
A young man complains of chest pain that is worse on palpation. What is the ECG diagnosis?
I aVR V1 V4

II aVI V2 V5

III aVF V3 V6
 Self Assessment Quiz 91

Question 22
A 27 year old man presents with chest pain worse on movement. What is the ECG diagnosis?
I aVR V1 V4

II aVI V2 V5

III aVF V3 V6

Question 23
A 47 year old woman complains of central chest pain. What is the diagnosis?

I aVR V1 V4

II aVI V2 V5

III aVF V3 V6
92 ABC of Clinical Electrocardiography

Question 24
A 76 year old woman with hypertension presents with palpitations. What is the ECG diagnosis?

I aVR V1 V4

II aVL V2 V5

III aVF V3 V6

Question 25
A 67 year old man develops chest pain and is hypotensive. What is the ECG diagnosis?

I aVR V1 V4

II aVL V2 V5

III aVF V3 V6
 Self Assessment Quiz 93

Question 26
A 23 year old man complains of palpitations. What is the ECG diagnosis?

I aVR V1 V4

II aVI V2 V5

III aVF V3 V6

Question 27
A 48 year old man complains of pain on swallowing. What is the ECG diagnosis?

I aVR V1 V4

II aVI V2 V5

III aVF V3 V6
94 ABC of Clinical Electrocardiography

Question 28
A woman complains of central chest pain. What is the diagnosis?
I aVR V1 V4

II aVI V2 V5

III aVF V3 V6

Answers
Answer 1 Answer 9
Third degree heart block and ST segment elevation associated An idioventricular rhythm. Note the second beat is sinus.
with an inferior myocardial infraction. (See Chapter 6.)
(See Chapter 8.)
Answer 10
Answer 2 Atrial tachycardia with 2:1 block due to digoxin toxicity.
Trifascicular block. Exhibited by right bundle branch block. Left
axis deviation and first degree heart block. Answer 11
Sinus arrhythmia.
Answer 3
Prolonged QT interval. The QT interval measures 0.56 seconds. Answer 12
The QT interval is greater than 50% of the R-R interval. Atrial fibrillation. Note the coarse fibrillation waves.
(See Chapter 4.)
Answer 4
Multifocal atrial tachycardia. Answer 13
Regular narrow complex tachycardia—atrioventricular re-entry
Answer 5 tachycardia (AVRT). The presence of an inverted P wave in the
Myocardial ischaemia. Peaked T waves in association with ST segment indicates the presence of an accessory pathway.
widespread ST segment depression.
(See Chapter 10.) Answer 14
Hypothermia. Sinus bradycardia and J waves in the anterior
Answer 6 chest leads.
Regular broad complex tachycardia—ventricular tachycardia.
The abnormal axis, right bundle branch block pattern and Answer 15
concordance all strongly suggest ventricular tachycardia. Polymorphic ventricular tachycardia. A fast broad complex
tachycardia that is irregular. Note the variable morphology of the
Answer 7 QRS complexes. This patient had a prolonged QT interval when
Regular narrow complex tachycardia. The rate and absence of in sinus rhythm. Her resting ECG is seen in Question 3.
P waves suggest that this rhythm is an atrioventricular nodal
re-entry tachycardia (AVNRT). Answer 16
Evolving anterolateral myocardial infarction. Subtle ST
Answer 8 segment elevation is present in lead I, aVL and peaked T waves
Anterior myocardial infarction. Right bundle branch block. Atrial in the anterior chest leads. Note the reciprocal changes in the
flutter. inferior leads.
 Self Assessment Quiz 95

Answer 17 Answer 24
A broad complex tachycardia that is irregular. There is atrial Regular broad complex tachycardia. Default diagnosis is
fibrillation with left bundle brand block. ventricular tachycardia. In this case, however, the correct
diagnosis was atrial flutter with rate dependent bundle
Answer 18 branch block.
Left ventricular hypertrophy with tall R waves in association with
ST segment depression.
Answer 25
Answer 19 Ventricular tachycardia with left bundle branch pattern.
Hyperkalaemia. Broad complexes with peaked T waves. Absent Note the presence of a fusion beat as the fourth complex
P waves. in leads V1 – V3.

Answer 20 Answer 26
Ventricular fibrillation. Irregular broad complex tachycardia. Atrial fibrillation in a
Answer 21 patient with Wolff-Parkinson-White syndrome. Note the variable
Benign early repolarisation. There is a notch at the J point in morphology of the QRS complexes.
association with ST segment elevation which is most marked in
lead V4. Answer 27
Pericarditis. There is widespread ST segment elevation
Answer 22 and, with the exception of aVR, there are no reciprocal
Normal ECG. changes.
Answer 23
A myocardial ischaemic widespread ST depression and T wave Answer 28
inversion. Posterior myocardial infarction.
(See Chapter 3.)