Patient Details: A 68-year-old male,retired professional,residing in Mumbai.
Medical History: Cardiovascular disorders since last several years and referred to Suburban Diagnostics by his physician for a 2D echo. An ECG done in the recent past was relatively normal with some changes indicating IHD but without any arrhythmias.
Clinical presentation: New onset dyspnoea on exertion NYHA class II/IV.
Tests done: 2D Echo revealed severe LV systolic dysfunction.
Clinical Suspicion: The reporting cardiologist Dr.Ravi strongly suspected a cardiac arrhythmia. Hence, he connected with the patient proactively and requested him to undergo an ECG to better understand the condition. The patient was highly reluctant and refused to get an ECG done as it was not advised by his physician. Therefore, we offered him an ECG free of cost. Hence, the patient agreed to get the ECG done.
Results: The ECG showed AV dissociation.
Diagnosis based on the results: Atrioventricular dissociation suggestive of the need of cardiac pacemaker. Further expert cardiac consultation and clinical correlation was warranted. The referring physician Dr. U G Shirodkar was immediately informed about the condition and the patient was counseled for the need for hospitalisation for pacemaker implantation.
Significance of this case (Take home messages): An ECG performed on a patient who was otherwise unwilling to undergo the tests, ended up revealing that the patient had a life threatening cardiac arrhythmia and needed pacemaker surgery. The Suburban Diagnostics team could help diagnose an urgent clinical need of the patient that would have otherwise gone unnoticed or would have created a medical emergency had it gone missed.