This is a 65 year old man, presents with dyspnea at rest, recent decline in function, and no change in medications. He is currently taking hydrochlorthiazide, carvedilol, tiotropium, and aspirin.
What does his EKG suggest is the cause of his dyspnea?
What does his EKG suggest is the cause of his dyspnea?
No idea what is going on in this EKG. But, maybe the main finding is prominent R wave in V1.
The differential diagnosis of tall R waves in lead V1:
Right bundle branch block
Left ventricular ectopy
Right ventricular hypertrophy
Acute right ventricular dilation
Wolff-Parkinson-White syndrome Type A
Posterior myocardial infarction
Hypertrophic cardiomyopathy
Progressive muscular dystrophy
Dextrocardia
Misplaced precordial leads
Normal variant
(Brady, et al. Prominent R Wave in Lead V1: Electrocardiographic Differential Diagnosis; Am J Emerg Med 2001;19:504-513:)
Of those options I'd say posterior MI fits the picture of a person who presents with dyspnea at rest.
Thats my guess.
Not 100% sure but can be
Rt Ventricular Hypertrophy:
-RAD
-deep S-wave in v5 and v6.
-incomplete Rt bundle.
-also ? RAE in lead II.
This patient could have Primary pulmonary hypertension which would lead to RVH and dyspnea.
Also I think there is septal infarct?