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Gepubliceerd in: Netherlands Heart Journal 9/2018

Open Access 02-08-2018 | Rhythm Puzzle – Question

A peek behind the curtain

Auteurs: M. Kamali-Sadeghian, P. T. G Bot, R. Tukkie, H. J. Wellens, D. J. van Doorn

Gepubliceerd in: Netherlands Heart Journal | Uitgave 9/2018

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Question

A 67-year-old male was referred to the outpatient clinic of our hospital with crescendo angina pectoris since one month. He had been diagnosed with atrial fibrillation in a general practice three days earlier and treatment with metoprolol and apixaban was initiated. He was an otherwise healthy and active cyclist who smoked a cigar on occasion. There were no other risk factors for coronary artery disease. An echocardiogram performed five years ago because of persistent bradycardia, was normal.
Physical and laboratory examination on admission did not reveal any abnormalities. His initial troponin I level was 11 ng/l, with repeat troponin I concentration found at 14 ng/l (normal range 0–10 ng/l). The resting electrocardiogram at presentation is shown in Figs. 1 and 2.
What is your diagnosis based on the electrocardiographic findings?
What would be your next step or treatment?

Answer

You will find the answer elsewhere in this issue.
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://​creativecommons.​org/​licenses/​by/​4.​0/​), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
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Metagegevens
Titel
A peek behind the curtain
Auteurs
M. Kamali-Sadeghian
P. T. G Bot
R. Tukkie
H. J. Wellens
D. J. van Doorn
Publicatiedatum
02-08-2018
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
Netherlands Heart Journal / Uitgave 9/2018
Print ISSN: 1568-5888
Elektronisch ISSN: 1876-6250
DOI
https://doi.org/10.1007/s12471-018-1139-8