An 85 year old lady with with a central chest ache and an abnormal ECG

Authored by Dr Christine A’Court. GP cardiologist, Oxford.

A sprightly 85 year old lady whose only medical history was of well controlled hypertension had her handbag snatched when in her GP surgery’s waiting room. She was understandably distressed and the following day developed unusual fatigue and then 30 mins central chest ache, without other symptoms. Her GP attended, found her BP lower than usual and arranged an ECG (attached). Her only previous ECG, obtained 14 years earlier, was reportedly normal. When she attended a community cardiology clinic some weeks later she reported mild fatigue and exertional breathlessness. Her examination showed a soft Ejection Systolic Murmur at the left sternal edge and a repeat ECG was the same as the most recent.


Current ECG


ECG from a month ago

Continue reading “An 85 year old lady with with a central chest ache and an abnormal ECG”

An incidental finding in a 40 year old

Authored by Dr Lisanne Schoutens (FY2 Doctor, John Radcliffe Hospital, Oxford)

A fit and well 40 year old man was referred to cardiology clinic due to an incidental finding on his ECG. He has no significant cardiac or other past medical history and takes no regular medications. He is adopted, and his family history is unknown. In clinic, his observations and bloods were all normal. Echocardiogram demonstrated a structurally normal heart and good biventricular function

Continue reading “An incidental finding in a 40 year old”

A 35 year old woman with palpitations

Authored by Dr Francesca Finch (FY2 doctor, John Radcliffe hospital Oxford)

HPC: A 35 year old woman was admitted with a 2 day history of palpitations associated with intermittent dizziness. Her symptoms started suddenly when she was working at her desk. She did not experience any chest pain. Observations were stable throughout.

She had a similar episode occurred 6 months previously which was self-limiting, for which she did not seek medical attention.

She is normally fit and well, with no significant past medical history or regular medications.

Blood tests were all within normal range, and bedside ECHO showed a structurally normal heart. Continue reading “A 35 year old woman with palpitations”