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Chathur 5 year old Boy,Known patient with Ventricular Septal Defect , brought to the hospital by his mother complaining of  Sudden Weakness of the Right Leg and fallen on the ground 2days back.This was happened four times on that day.There was no loss of Consciousness,Sudden loss Of Vision,Fits and Vomiting associated with that above  event.
This child did not have any significant past surgical history and child was regularly followed up by a  cardiologist

On examination of this Child

He was not Febrile,not pale and not Icteric.There was no finger or toe clubbing.No facial  Puffiness or pitting ankle Odema
Cardio Vascular System - Pan Systolic Murmur best heard at the Left sternal Edge
Cenral Nervous System - No abnormality Detected
Other System Examinations also uneventful

What are the differential Diagnosis?
What are the other relevant things that you would  ask in the history?
What are the Investigations you would like to do for confirmation of your Dx?


ECG Abnormalities_Part03

Friday, January 8, 2010

79 year old woman complaining of attacks of dizziness for the past.These Attacks are infrequent but come on any time, without obvious precipitating events And the attacks could occur  in any posture.She had never had Chest pain.Apart from these attacks she was very well.
But her Physical examination reveal that she was having a regular heart with a rate of 40bpm.
And there were no murmurs or signs of cardiac  enlargement.

  1. How would you explain her attacks of dizziness with the aid of the ECG given above???


4 years old male child with ecchymotic patches on both knees and gum bleeding. He has had Similar episodes  during the last 3 years for which they have taken treatment at the local hospital. He was given two plasma transfusions during this time.He was Only child in the family, non consanguineous marriage of parents.And his  maternal aunt has similar bleeding history.

Full blood count including the Platelets is normal. 
PT Normal, APTT 45 sec 

  1. What is the Dx???
  2. Discuss further investigations and possible treatment???

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