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Normal ECG. A 55 year old man with 4 hours of "crushing" chest pain. A 63 year old woman with 10 hours of chest pain and sweating. A 60 year old woman with 3 hours of chest pain. A 53 year old man with Ischaemic Heart Disease. A 79 year old man with 5 hours of chest pain.

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A 90 year old lady with syncope
A 90 year old lady with syncope. mid-diastolic murmur.


A 34 year old woman with asthma
A 34 year old woman with asthma mid-diastolic murmur.


A 60 year old man with htn
A 60 year old man with HTN mid-diastolic murmur.


A48 year old man with palpitation
A48 year old man with palpitation mid-diastolic murmur.


A 76 year old man with sob
A 76 year old man with SOB mid-diastolic murmur.


A 60 year old woman with htn
A 60 year old woman with HTN mid-diastolic murmur.




A woman with romano ward syndrome
A woman with Romano-Ward Syndrome mid-diastolic murmur.


QTc mid-diastolic murmur.

Normal QTc

  • Men < 0.43

    • borderline o.43-0.45

    • prolonged >0.45

  • Women < 0.43

    • borderline o.43-0.47

    • prolonged >0.47




A 69 year old man 2weeks post iwmi
A 69 year old man 2weeks post IWMI mid-diastolic murmur.


A 60 year old man with ihd
A 60 year old man with IHD mid-diastolic murmur.





What is the rhythm
What is the rhythm? suddenly collapses


Dual chamber pacer with an icd
Dual chamber pacer with an ICD suddenly collapses



Wolf parkinson white syndrome
Wolf-Parkinson-White syndrome suddenly collapses

  • short PR interval, less than 3 small squares (120 ms)

  • slurred upstroke to the QRS indicating pre-excitation (delta wave)

  • broad QRS

  • secondary ST and T wave changes

    • Localising the accessory pathway

  • An accessory pathway, bundle of Kent, exists between atria and ventricles and causes

  • early depolarisation of the ventricle. The location of the pathway may be deduced as follows:-

  • LOCATION V1 V2 QRS axis

  • left posteroseptal (type A) +ve +ve left

  • right lateral (type B) -ve -ve left

  • left lateral (type C) +ve +ve inferior (90 degrees)

  • right posteroseptal -ve -ve left

  • anteroseptal -ve -ve normal


  • A 47 year old man with a long history of palpitations and blackouts
    A 47 year old man with a long history of suddenly collapsespalpitations and blackouts.








    A 64 year old woman on digoxin
    A 64 year old woman on digoxin suddenly collapses


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