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  #1  
Old 05-13-2012
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EKG EKG Abnormality Diagnosis

A 20-years male has one weeek complaining for weakness and syncopal episode, decides to visit a cardiologist about that. The boy has no significant past medical history and is not taking any medications. An ECG obtained in the clinic is showing that(See the ECG). Which of the following should be the diagnosis in this 20-years male?


A) Cardiac cell sarcomere proteins
B) Myxomatous degeneration due to connective tissue protein
C) Back-to-back atrial depolarization wave
D) Polymorphous ventricular tachycardia
E) Both P wave and QRS complexes are present

EKG Abnormality Diagnosis-ekg.jpg
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  #2  
Old 05-13-2012
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Looks like Torsades... I go with D....

Congenital Long QT syndromes.. Romano Ward or Jerville Lange sndromes. ?
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  #3  
Old 05-13-2012
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Default d

torsades d
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  #4  
Old 05-13-2012
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This looks like ventricular tachycardia to me. Arrhythmia + syncope in a healthy young patient... either K channel issues or hypertrophic cardiomyopathy. Since we don't have more info, I think its safe to say that K channels are not the issue here. I only can think of sarcomere proteins abnormality.

B) I think this could be Marfan Sx. or Ehlers-Danlos Sx.
C) Not sure about this... AV reentrance is WPW disease right???
D) I don't know the real definition of this option
E) Clearly, we don't have P waves or QRS complexes here...
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Last edited by Dr. Mexito; 05-13-2012 at 06:16 PM.
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  #5  
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D for sure
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  #6  
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Quote:
Originally Posted by Dr. Mexito View Post
This looks like ventricular tachycardia to me. Arrhythmia + syncope in a healthy young patient... either K channel issues or hypertrophic cardiomyopathy. Since we don't have more info, I think its safe to say that K channels are not the issue here. I only can think of sarcomere proteins abnormality.

B) I think this could be Marfan Sx. or Ehlers-Danlos Sx.
C) Not sure about this... AV reentrance is WPW disease right???
D) I don't know the real definition of this option
E) Clearly, we don't have P waves or QRS complexes here...

Come on my man that is very easy to make the Dx
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D for sure
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  #8  
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Quote:
Originally Posted by alfjof View Post
Come on my man that is very easy to make the Dx
Yeah man... I over analyze the question

P.S.
I tend to do that from time to time
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Old 05-13-2012
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I would also go for " Torsade de Pointes" , the option " D ".
It looks like classic.
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  #10  
Old 05-14-2012
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Default Explanation

A) Cardiac cell sarcomere proteins: Hypertrophy cardiomyopathy(but is unrelated with the EKG case)
B) Myxomatous degeneration due to connective tissue protein: Mitral valve prolapse(Marfan, Ehrles-Danlos, APKD)
C) Back-to-back atrial depolarization wave: Atrial flutter
D) Polymorphous ventricular tachycardia: Congenital long QT syndrome, or torsades de pointes, or Jervell and Lange-Nielsen syndrome(correct answer) FA 2010 p258
E) Both P wave and QRS complexes are present: 3rd-degree heart block(Lyme disease)
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  #11  
Old 05-14-2012
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Default

Quote:
Originally Posted by Dr. Mexito View Post
Yeah man... I over analyze the question

P.S.
I tend to do that from time to time

Sorry if I was confused you, so you got the explanation and remember between 35-45% in the test will look like all questions I posted in this forum, the board won't give to you a direct Dx in the answer of choice ok. I will post one later I had in my real......... in December, see you later man, keep studing!!!!!!!!!!!!!!!!!!!
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  #12  
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D for sure
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