Canadian Journal of Rural Medicine

: 2019  |  Volume : 24  |  Issue : 4  |  Page : 121-

Country cardiograms case #66

Charles William Helm 
 Tumbler Ridge Health Centre, Tumbler Ridge, Canada

Correspondence Address:
Charles William Helm
Tumbler Ridge Health Centre, Tumbler Ridge

How to cite this article:
Helm CW. Country cardiograms case #66.Can J Rural Med 2019;24:121-121

How to cite this URL:
Helm CW. Country cardiograms case #66. Can J Rural Med [serial online] 2019 [cited 2020 Aug 8 ];24:121-121
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A 56-year-old male patient is sent to a remote emergency room (ER) in British Columbia, with a week-long history of wheezy chest, persistent cough, production of yellowish sputum and shortness of breath. He has previously been diagnosed with chronic obstructive pulmonary disease (COPD). Relevant findings on examination include being afebrile, a respiratory rate at rest of 16/min, oxygen saturation in room air of 90% and crackles in the right upper lung zone. His chest X-ray shows pneumonic consolidation in the right lobe and hyperinflated lung fields and flattened diaphragms, suggestive of COPD. A 12-lead electrocardiogram (ECG) is also obtained [Figure 1]. What are the striking features seen in this ECG that may be of relevance to the likely diagnosis of pneumonia superimposed on COPD?