Tuesday, April 04, 2006

Case Study day

In order to fulfill some obligations as a faculty member of a foregin institution some travel will be required over the next couple of days. So all my dear readers get to enjoy yet another case study. By the way, unless we get some replies or comments, no answers will be posted.

Today's case study features a few tongue twisting conditions.

MM is a 60yr old Malay gentleman with a months history of progressive effort dyspnea, culminating in orthpnea and PND over the last 1 week. He is a known diabetic (moderately well controlled) for the last 6 yrs. He smokes about 20 cigs/day for the last 30 yrs. Clinical examination was unremarkable. The BP is 160/90 mmHg, HR 90/min.

Attached is an ECG which would be typical of a gentleman in his condition.

What would you diagnose? What would you tell Mr. MM?

Incidentally, research tells us that third year medical students have just as good a chance as any non-cardiologist of coming up with a good answer :)


Kent said...

Does he have AF?

Jan said...

CHF due to flutter?
Calipers don't work well on the computer screen to see if p waves march out :)
He needs diuresis, BP control.
If it is flutter, then a trial of cardioversion, if not successful, send him for ablation.

Dr Ng Swee Choon said...

Reply posted at