A 60 year old marathon runner complains of dizziness episodes. On auscultation ejection systolic murmur is heard. ECG is done. Clinical diagnosis is?
The ECG shows hea rate of 50/min with left axis. Patient is in normal sinus rhythm. QRS duration is normal. T wave inversion is noted in lead I, aVL and V5-V6 indicating possible ischemic changes. Depth of S wave in V1 =20mm Height of R wave in V5= 30mm SV1 + RV5/6(tallest R in either V5 or V6) >35 mm is diagnostic of Left ventricular hyperophy( Sokolov- Lyon criteria) The low hea rate is explained by high vagal tone seen in marathon runners.
HTN with Atrial fibrillation
LVH with Valvular Aoic stenosis
RVH with Valvular Pulmonic stenosis
Brugada Syndrome
Hea Sounds