Cardiologist Challenge Cases – Veterinary ECG Quiz

Dog - Akita cross (Recorded with Beecardia)

14 years • Male

Question

Which rhythm diagnosis best fits this tracing?

Frequent atrial premature complexes

Marked sinus arrhythmia

Atrial fibrillation

Supraventricular tachycardia

Cat (Recorded with Beecardia)

Female

Question

Does this recording contain a rhythm abnormality, and if so, which one?

Ventricular tachycardia with intermittent sinus capture beats

Sinus rhythm with intermittent aberrant conduction of single beats

Normal sinus rhythm with no ectopic complexes

Sinus rhythm with occasional isolated ventricular premature complexes

Cat (Recorded with Beecardia)

Question

Which rhythm diagnosis does this recording support?

Supraventricular tachycardia

Atrial flutter

Atrial fibrillation

Sinus tachycardia

Dog (Recorded with Beecardia)

Male • Receiving pimobendan

Question

Ventricular ectopy is present in this dog. What is the highest-grade grouping of consecutive ventricular beats in this recording?

Singlets - the ectopic beats never occur back-to-back

A couplet - two consecutive ventricular beats

A triplet - three consecutive ventricular beats

A run of ventricular tachycardia - a sustained string of consecutive beats

Cat - Domestic short hair (Recorded with Beecardia)

17 years • Female • Seizure and stumbling about 20 minutes before presentation; no further episodes at the clinic

Question

Which finding excludes a ventricular origin for these QRS complexes?

A P wave precedes every QRS at a constant PR interval

The complexes hold one uniform shape throughout

The R-R intervals stay regular from beat to beat

The heart rate sits within the normal feline range

Dog - Labrador Retriever (Recorded with Beecardia)

7 months • Male

Question

How would you classify the ventricular rhythm here?

Ventricular tachycardia

Accelerated idioventricular rhythm

Third-degree AV block with ventricular escape

Sinus tachycardia with bundle branch block

Cat (Recorded with Beecardia)

Male

Question

Which mechanism best explains the ventricular rhythm in this tracing?

Every second atrial impulse is blocked at the AV node, halving the ventricular rate

An irritable ventricular focus is firing faster than the sinus node and dominating the rhythm

No atrial impulses reach the ventricles, so a subsidiary ventricular pacemaker sets the rate

Sinus impulses are still reaching the ventricles but are widened by bundle branch block

Dog - Corgi (Recorded with Beecardia)

7 months • Male • Echocardiogram raised concern for third-degree (complete) AV block; an echogenic structure at the level of the aortic valve was suspicious for a thrombus. Contractility otherwise preserved, with only trivial mitral, tricuspid and pulmonary regurgitation and no evidence of significant pulmonary hypertension

Question

The referring echocardiogram raised concern for third-degree AV block. Which feature of this tracing argues against that diagnosis?

Complete absence of P waves with normal-width QRS complexes

Independent P waves marching through the QRS complexes

Irregularly irregular R-R intervals with a fibrillatory baseline

Wide, bizarre QRS complexes at a slow escape rate

Dog - Cocker Spaniel (Recorded with Beecardia)

12 years • Female

Question

Weighing the findings in this recording together, which conclusion about their clinical significance is best supported?

Sinus node dysfunction significant enough to warrant further evaluation

A benign vagally mediated pattern of no clinical consequence

High-grade AV block as the primary conduction problem

First-degree AV block as the main clinically relevant abnormality

Dog (Recorded with Beecardia)

11 years • Recheck ECG during ongoing oral antiarrhythmic therapy for a known ventricular arrhythmia. Eupneic with clear lungs; pulse deficits noted on exam

Question

What does this recording call for in a dog whose ventricular arrhythmia is already being treated?

Continue the current antiarrhythmic regimen unchanged and reassess at follow-up

Escalate antiarrhythmic therapy and arrange follow-up reassessment of rhythm control

Discontinue antiarrhythmic therapy and quantify the remaining ectopy by Holter

Accept the ectopy as adequately controlled and reassess at the next visit

Quiz: Cardiologist Challenge Cases

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