Record s20041
- Age: 60
- Sex: Male
Additional data
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Comments
This is a difficult record. The baseline ST segment is abnormal, it is scooped and slightly depressed. There are a number of episodes of ST depression associated with increased heart rate, some of which are quite prolonged. These events were suggestive of ischemia, and were so labeled. Lead 0 shows many ischemic episodes and a few axis shifts. Lead 1 shows many ischemic episodes, and the morphology of the QRST complexes is quite similar to those of lead 0. Electrode locations were not recorded.
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Diagnoses
Coronary artery disease Previous coronary artery bypass grafting, 1986 Congestive heart failure Chronic obstructive pulmonary disease Previous transurethral resection of the prostate Chronic renal failure (serum creatinine = 2.2)
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Treatment
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Medication
Nifedipine Isordil Metoprolol Captopril Lasix KCl Restoril Aspirin - Balloon Angioplasty: No
- Coronary Artery bypass Grafting: Yes, 1986
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History
- Comments: Exertional angina, dyspnea on exertion
- Hypertension: No
- Left ventricular hypertrophy: Yes
- Cardiomyopathy: No
- Valve disease: No
- Electrolyte abnormalities: No
- Hypercapnia, anemia, hypotension, hyperventilation: No
- Atrioventricular nodal conduction delay: No
- Intraventricular conduction block: Incomplete right bundle branch block
- Previous Myocardial Infarction: Yes, unknown date
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Previous tests
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ECG stress test
- Thallium/Stress echo: No
- Left ventricular function: No data
- Echocardiogram: No data
- Coronary Arteriography: June, 1997 - 99%left main coronary artery, 100%left anterior descending coronary artery, 100%left circumflex coronary artery. Internal mammary artery graft open but left anterior descending coronary artery occluded below anastamosis
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Baseline ECG
Normal sinus rhythm at 66 bpm Left ventricular hypertrophy Previous anterolateral myocardial infarction Inferior ischemia Possible old inferior myocardial infarction
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Holter Recording
- Date: 21/05/1997
- Recorder: ICR