Electrocardiogram interpretation: Test your skills with these 5 questions
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Gary S. Ferenchick, MD, MS, FACP, is a Professor of Internal Medicine at Michigan State University, East Lansing. Dr. Ferenchick is also a faculty member of the National Family Medicine Board Review course and creator of www.justintimemedicine.com.

Question 1 of 5

A 68-year-old man presents to the emergency department (ED) for dyspnea on exertion for the past 3 days. He denies chest pain, cough, orthopnea, or paroxysmal nocturnal dyspnea.

His history reveals he has hypercholesterolemia and a 10-year history of hypertension. He is maintained on lisinopril 20 mg/d, simvastatin 20 mg/d, and tadalafil 10 mg, as needed.

His physical examination reveals a blood pressure (BP) of 146/96 mm Hg, a respiratory rate of 18 breaths/min, and a room air oxygen saturation of 92%. He has no jugular venous distension and he has clear lungs in all fields. His heart examination reveals a regular rhythm, with no murmurs or extra sounds. He has normal peripheral pulses and no peripheral edema.

Electrocardiogram

His 12-lead electrocardiogram (EKG) shows:

Sinus rhythm, an axis of +60 and no other abnormalities.

First-degree atrioventricular (AV) block, an axis of +90, and evidence of a remote inferior wall myocardial infarction (MI).

Second-degree AV block, an axis of +90 and evidence of a remote anterior wall MI.

First-degree AV block, an axis of +60, and evidence of a remote anterior wall MI.

This quiz is not accredited for CME.

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