1. 70 yr old with lethargy and presyncope
Type II AV block – Mobitz II

2. Same patient few minutes later
Type II block – Wenkebach/Mobitz I

3. Same patient yet again…
Complete heart block – Third degree block

4. 70 yr old with lethargy and syncope
Trifascicular block – 1st degree HB, RBBB and LAD (L anterior hemiblock)

5. 50 yr old with palpitations
Capture beats
Fusion beat
Monomorphic VT

6. R on T causing polymorphic VT = Torsade's du pointe

7. You don’t want this for your patient
Ventricular Fibrillation

8. 30 yr old male with syncope
Brugada Syndrome

9. Brugada Syndrome ECG Findings T-wave α types Three types
ST elevation v1 – v3 > 2mm
Complete or incomplete RBBB
T-wave α types
1. Inverted
2. Biphasic
3. Upright

10. Brugada – Why do we care?
Predisposition to polymorphic ventricular tachycardia
Identification and treatment with AICD may prevent a young sudden cardiac death

11. 25 year old with syncope on exercising
Arrthymogenic RV cardiomyopathy/dysplasia - inverted T waves in leads V1 through V5. Arrowheads point to late RV activation, called an epsilon wave

12. When to refer cardiac syncope to ED
All 2nd degree and 3rd degree heart blocks
All trifascicular blocks
All rapid AF >120
All SVTs in not terminated by Valsalva manouvre
“funny looking” ST/T segments – discuss/fax
Asymptomatic patients with WPW, ST changes can be referred to cardiology OPA

13. Important contact details for Northern Hospital Nov 2013
Clinical ED Consultant – /
ED Fax –
EMET/General enquiries –
(Kim Tarzia ED secretary)
EMET queries to Dr Cynthia Lim, Dr Peter Jordan,
Dr Megan Robb
ED Director – Dr Shyaman Menon
EMET presentations :
Adult Outpatients – /
Fax –
Cardiology –
Fax –
(currently 3 month wait for Chest pain clinic)
Paediatric/Paed Surgery OPA –
Fax –
(current 4-6 week)(apmt sent 1 week)
Paediatric Surg Fax – (within a week)

14.
Click on EMET on left to access presentations provided.
Registrar education sessions and interesting education links

15. 70 yr old with lethargy and presyncope
Type II AV block – Mobitz II

16. Same patient few minutes later
Type II block – Wenkebach/Mobitz I

17. Same patient yet again…
Complete heart block – Third degree block

18. 70 yr old with lethargy and syncope
Trifascicular block – 1st degree HB, RBBB and LAD (L anterior hemiblock)

19. 50 yr old with palpitations
Capture beats
Fusion beat
Monomorphic VT

20. R on T causing polymorphic VT = Torsade's du pointe

21. You don’t want this for your patient
Ventricular Fibrillation

22. 30 yr old male with syncope
Brugada Syndrome

23. Brugada Syndrome ECG Findings T-wave α types Three types
ST elevation v1 – v3 > 2mm
Complete or incomplete RBBB
T-wave α types
1. Inverted
2. Biphasic
3. Upright

24. Brugada – Why do we care?
Predisposition to polymorphic ventricular tachycardia
Identification and treatment with AICD may prevent a young sudden cardiac death

25. 25 year old with syncope on exercising
Arrthymogenic RV cardiomyopathy/dysplasia - inverted T waves in leads V1 through V5. Arrowheads point to late RV activation, called an epsilon wave

26. When to refer cardiac syncope to ED
All 2nd degree and 3rd degree heart blocks
All trifascicular blocks
All rapid AF >120
All SVTs in not terminated by Valsalva manouvre
“funny looking” ST/T segments – discuss/fax
Asymptomatic patients with WPW, ST changes can be referred to cardiology OPA

27. Important contact details for Northern Hospital Nov 2013
Clinical ED Consultant – /
ED Fax –
EMET/General enquiries –
(Kim Tarzia ED secretary)
EMET queries to Dr Cynthia Lim, Dr Peter Jordan,
Dr Megan Robb
ED Director – Dr Shyaman Menon
EMET presentations :
Adult Outpatients – /
Fax –
Cardiology –
Fax –
(currently 3 month wait for Chest pain clinic)
Paediatric/Paed Surgery OPA –
Fax –
(current 4-6 week)(apmt sent 1 week)
Paediatric Surg Fax – (within a week)

28.
Click on EMET on left to access presentations provided.
Registrar education sessions and interesting education links