Squiggler

Breathlessness during a viral chest infection

The case

55-year-old woman. Breathlessness during a viral chest infection

Dilated cardiomyopathy with a documented left bundle branch block. No chest pain and no syncope.

On arrival

HR
84
GCS
15
SpO₂ (%)
98
Respiratory rate
16
Temperature (°C)
36.7
Systolic BP (mmHg)
126
Diastolic BP (mmHg)
74

Stage 1 of 1

She is mildly breathless but haemodynamically stable.

The tracing for the quiz “Breathlessness during a viral chest infection”.
Twelve-lead recorded on arrival, 25 mm/s, 10 mm/mV. Open this tracing in the studio

Observations

HR
84
SpO₂ (%)
98
Respiratory rate
16
Temperature (°C)
36.7
Systolic BP (mmHg)
126
Diastolic BP (mmHg)
74
What conduction abnormality is present?
How should the ST-T changes be interpreted?
Which additional ECG feature would be most concerning for acute coronary occlusion?

Diagnosis

Chronic complete left bundle branch block with secondary repolarisation changes

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<iframe src="https://www.squiggler.io/blog/breathlessness-during-a-viral-chest-infection/embed" title="Breathlessness during a viral chest infection — ECG case from Squiggler" width="100%" height="900" style="border:0" loading="lazy"></iframe>

This tracing was generated, not recorded. It opens in the studio with every dial live.

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Discussion

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