The Patient with syncope: ECG Quiz

This week I am putting on a 30 minute webinar on The Approach to the patient with Syncope.
Date: Thursday July 22nd at 3.00pm (Melbourne Time)
Here is the Zoom link: 
​https://us02web.zoom.us/j/87324913445?pwd=VkwwcHhjdHZJd09JT2N3c214RDVKdz09

Before the Webinar Try your hand at these few ECGs.

The ECG has a < 5% yield but is still the highest yield of all investigations we can do in the syncope patient. It's importance cannot be understated,  as cardiac causes of syncope have the highest mortality and morbidity of all causes.

Below are 7 ECGs of patients that present with syncope

What is the diagnosis in each case?

ECG 1: 

A 30 yo male presents with his third episode of syncope. He was waiting for a bus and felt a brief episode of palpitations then found himself on the ground. He has no past medical history by states that his father died suddenly of unknown causes.
He has had a cardiac workup during a previous presentation, which included monitoring,  serial troponins and an echocardiogram, which were all normal.
What does the ECG show?

ECG 2

A 78 yo male is brought in by ambulance following a fall at home. He has no memory of the incident. He states that he was making a cup of tea, felt dizzy and then found himself on the floor of his kitchen. He couldn't get up and called for help. His wife called the ambulance.
What does his ECG show?
What probable definitive treatment will he need?

ECG 3

A 56 yo male presents with a syncopal episode. He had momentary dizziness, but no shortness of breath or palpitations or chest pain.
What does the ECG show and what caused his syncopal episode?

ECG 4

A 56 yo woman has presented to the emergency department following a brief syncopal episode. The patient had no chest pain, or palpitations. Following the ECG and serial normal troponins, the patient was discussed with the senior as a possible discharge.
​The senior wanted cardiology called and an admission. What was missed?
What is the diagnosis?

ECG 5

A 38 yo greek man is brought in by ambulance as he collapsed, whilst playing soccer. He has no past medical history and has had some previous episodes of palpitations in the past.
He is well and wishes to go home.
What does the ecg show?
​What waveform is shown in leads V1 and V2?

ECG 6

A 28 yo woman presents with palpitations and a syncopal episode. She is haemodynamically stable and looks well. There has been a history of syncope.
What is the diagnosis?
What is the treatment, or even more precisely, what medications can't we give?

ECG 7

A 32 yo male is brought into the emergency department with a diagnosis of seizures. He has had several small seizures according to his partner.
He is on the methadone program.
His ecg is shown, what is the diagnosis?
​Is there a reason related to the ecg that could describe the seizures?

Try all of these. Join the zoom webinar this week. If you can't

​ make it, don't worry, I'll put up the video here next week.