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01-03-2019 | Rhythm Puzzle – Question | Uitgave 4/2019 Open Access

Netherlands Heart Journal 4/2019

Left bundle, right diagnosis

Tijdschrift:
Netherlands Heart Journal > Uitgave 4/2019
Auteurs:
A. E. Schaafsma, C. Coolsma, H. Lameijer
A 79-year-old male was brought to the emergency department by emergency medical services (EMS) with retrosternal chest pain radiating to both shoulders. The pain started 2 hours ago while he was working in his garden. His medical history included hypertension, hypercholesterolaemia and a transient ischaemic attack. Physical examination showed tachypnoea, 37 breaths per minute, without abnormalities at pulmonary or cardiac auscultation, a heart rate of 88 beats per minute, a blood pressure of 111/73 mm Hg and unremarkable findings on abdominal examination. However, the patient looked clammy and grey. Nitroglycerine (GNT) administered sublingually relieved the pain. A partial electrocardiogram was performed by an EMS nurse (Fig. 1). Which abnormalities raise your concern?
A.
A new left bundle branch block
 
B.
The negative T wave in leads V5 and V6
 
C.
The ST depression in leads V2–V4
 
D.
The irregularity of the cardiac rhythm
 

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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