Atrial Arrhythmias

Case 14 answer

Atrial fibrillation 3


History:
This ECG was recorded from a 87 year-old lady presented with swollen ankles for 2 weeks. She denies chest pain and palpitation. She has mutiple medical problems- CHF, Hypertension, non-Q wave MI 3 months ago, Asthma/CORD. She is on Digoxin 125mcg, Accupril 10mg, Thyroxine 0.05mg, Frusemide 80mg, Somac 20mg, Becotide 100mcg inh and Atrovent 40 mcg inh.

ECG shows:

  • AF, rate ~50/min
  • Normal QRS axis, QRS duration, QT for rate
  • Q waves in V1-5 with poor R wave progression, possible old anterior MI.
  • Downsloping ST depression, consistent with effect of digoxin.
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