Squiggler

Progressive exertional breathlessness and one episode of near-syncope

The case

35-year-old woman. Progressive exertional breathlessness and one episode of near-syncope

Systemic sclerosis with known pulmonary arterial hypertension. No sudden pleuritic pain and no acute change in symptoms.

On arrival

HR
104
GCS
15
SpO₂ (%)
94
Respiratory rate
20
Temperature (°C)
36.5
Systolic BP (mmHg)
108
Diastolic BP (mmHg)
68

Stage 1 of 1

She is stable at rest. The ECG is recorded during routine assessment of worsening exercise tolerance.

The tracing for the quiz “Progressive exertional breathlessness and one episode of near-syncope”.
Twelve-lead recorded on arrival, 25 mm/s, 10 mm/mV. Open this tracing in the studio
What chamber abnormality is shown?
Which combination is most characteristic?
What does the associated tall P-wave morphology suggest?

Diagnosis

Right ventricular hypertrophy and strain from pulmonary arterial hypertension

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<iframe src="https://www.squiggler.io/blog/progressive-exertional-breathlessness-and-one-episode-of-near-syncope/embed" title="Progressive exertional breathlessness and one episode of near-syncope — 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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