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Image challenge
ECG worth a ‘few hundred’ words
  1. Shonda Ng1,
  2. Kevin Ming Wei Leong2,
  3. Pow-Li Chia1
  1. 1 Cardiology, Tan Tock Seng Hospital, Singapore
  2. 2 Cardiology, National Healthcare Group Woodlands Health Campus, Singapore
  1. Correspondence to Dr Shonda Ng, Cardiology, Tan Tock Seng Hospital, Singapore, Singapore; aviabloom{at}hotmail.com

https://doi.org/10.1136/emermed-2021-212252

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    Clinical introduction

    A 76-year-old Chinese woman presents to the emergency department with recurrent palpitations for 3 months. She has a medical history of diabetes mellitus, hypertension, hyperlipidaemia and minor coronary artery disease. Her palpitations were described as regular, rapid, with gradual onset, lasting up to 30 min on a weekly to fortnightly basis. On admission, there were presyncopal symptoms prompting her presentation. She was previously started on bisoprolol 2.5 mg once a day from another institute though no prior diagnosis or ECG was made or available. An ECG performed by the attending paramedics fortuitously caught the end of her palpitations (figure 1).

    Figure 1

    Initial ECG captured by paramedics, showing termination of palpitations.

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    Footnotes

    • Contributors SN carried out the writing and original draft preparation, review and editing of the final manuscript and figures for the article. KMWL carried out the writing, review and editing of the final manuscript and figures for the article. P-LC reviewed the final manuscript. All authors read and approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.