Fast Beats
Cardiovascular System
0
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M3_F1.jpg"}},{"insert":"\n\n"},{"insert":"It is your high school reunion. Despite a packed schedule, you\u0027ve somehow managed to take the evening off.\n\nYou have to thank your best friend Andre for this - he just wouldn\u0027t take no for an answer.\n\nAfter gulping down some punch, your mood lightens up.\n\nYou join Andre on the dance floor to recreate all the funky dance moves of your high school days.\n\nEnjoying himself enormously, Andre dances around. A short while later though, there is no sign of him on the dance floor.\n\nYou decide to step out and look for him.\n"}]}
1
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M3_F2.jpg"}},{"insert":"\n\n"},{"insert":"In the corridor outside, you see Andre sitting in a corner, holding his head in his hands.\n\n\u0022Are you all right, Andre?\u0022\n\n\u0022I feel dizzy and my heart is thumping\u0022, he responds.\n\nYou quickly check his pulse and note that it is around 160 bpm. You also notice that he is tachypneic.\n\nJust as you prepare to call 911, Andre opens his eyes and says that he feels better now.\n\nThe palpitations and dizziness have gone away. You quickly reassess his pulse and realize that it is now only 80 bpm.\n\n\u0022Has this happened before, Andre?\u0022, you ask.\n\n\u0022A couple of times, yeah, but it never lasts long. Forget it - let\u0027s go back to the party!\u0022\n\n\u0022No way!\u0022, you respond.\n\n\u0022You\u0027re going to the hospital with me!\u0022\n"}]}
2
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M3_F3.jpg"}},{"insert":"\n\n"},{"insert":"Once in the hospital, you obtain a detailed history from Andre.\n\nApparently, the previous attacks were extremely similar to the one he had today, lasting only a few seconds each time.\n\nHe is otherwise healthy, and extremely fit, being an enthusiastic amateur marathon runner.\n\nTo the best of his knowledge, there is no history of similar episodes in his family.\n\nAside from his grandfather, who died of a \u0027heart attack\u0027 at age 86, there is no family history of cardiac disease.\n\nNor is there a family history of sudden death at a young age.\n"}]}
3
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/M3_F4.jpg"}},{"insert":"\n\n"},{"insert":"You order a 12-lead ECG.\n\nThe ECG shows T inversions in leads V1-V3, as well as small terminal notches at the end of the QRS complexes.\n"}]}
4
{"ops":[{"insert":"What will your next step be?\n"}]}
1. Ambulatory ECG monitoring
2. Right Ventricular Angiography
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