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Wednesday, 26 March 2014

#ECGclass - Spring 5

Welcome to another weekly case on ECGclass. 
If you are new to @ECGclass, #ECGclass, or this blog - please click here to find out what it's all about! 

Enjoy. :)


#ECGclass  Spring 5

This 49yr old man presents to his GP with a 6 month history of chest pain.

Sometimes this is triggered by exertion, but sometimes it occurs at rest. 
It can be prolonged, often lasting several hours and on occasions, all weekend.

He considers himself fit and active, so he light-heartedly dismisses his symptoms. 
His job involves heavy labour, but he 'works through' his mild discomfort, which is very localised in the left upper chest, without radiation. 

Other than this, he feels great. 
He only came to see you under duress, from his wife, and feels he is wasting your time, and is keen to get back to work. He is self-contracted and tells you "Time, is money". 

He has no arm pain, no dizziness, and no breathlessness.

He is a non smoker, with no risk factors for IHD, and is not on any medication. 
His BP is normal, as always. However, you do hear a systolic heart murmur at the left sternal edge.

You obtain the ECG below:


What now?

He's sitting in front of you, feeling 'great' and looking clinically well.  


At the time of his consultation/ECG, he is pain free, but he admits the pains can come and go several times a day.

How are you going to take this consultation forward?



Please use the Hashtag #ECGclass if joining in on Twitter!

If you want to ask the patient any questions, or request any further information this can  be done by the live hashtag during the course of this evening.   

(Alternatively, if you are referring to this blog at a later date, please leave any comments below).

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