Recent ECG Case Highlights from the University of Maryland (Part II)

UMEM Potpourri ECG Cases with Dr. Amal Mattu

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HPI

A 67-year-old man arrives at the emergency department complaining of lightheadedness. The following ECG is obtained and shows a slow, regular rhythm around 40 beats per minute. The P waves seem to wander closer to and farther from the QRS complexes, as if they’re dancing around them.

Before watching this week’s workout, review the arrival ECG carefully and consider:

1. 1. Are the atrial beats conducting at all?
   2. Is this sinus bradycardia with an unusually short PR interval, or something more serious?
   3. What does it mean when the atrial and ventricular rhythms march independently but at nearly the same rate?