loop recorder of a pt complaining of palpitations. Appears t | Figure 1

loop recorder of a pt complaining of palpitations. Appears trigemeny w/ couplets.

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patient sent from DPM for evaluation/admission of RLE cellulitis; heard strange rhythm on auscultation and found this unique rhythm! Patient states clear cardiac cath recently without any cardiopulmonary complaints.](https://app.figure1.com/case-detail/1016a458-f57c-4dae-99ee-9a3f522c36be)



a great textbook strip for students, lots of great things here- I can see 3, potentially 4.](https://app.figure1.com/case-detail/13bd4a9c-0c3a-433d-963a-ae6eb1daaa08)



what are the features that make this an irregularly irregular rhythm?](https://app.figure1.com/case-detail/782b4c2c-0a1c-4bcd-be79-7684347cb9a7)



Update from prior case.

The rhythm is sinus, there are multiple PAC (atrial bigeminy) with aberrant intraventricular conduction. Anterior fascicular block, chronic T wave inversions over the lateral leads which are stable.
This is not a case of PVCs, I love this type of cases because they increase the logical thinking and methodic thinking when evaluating EKGs. The first question should be, what is the rhythm, and then figure out the rest.](https://app.figure1.com/case-detail/7fedaa2d-f9fe-4a6a-ba60-c1c8285e64e6)

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A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)



A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)



A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)



patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)