Quiz #27: EKGs on the day of surgery

6 yr old boy, s/p Repair of subaortic membrane. Two EKGs with time of recording are given - both were recorded on the day of surgery. Second EKG was performed because bedside nurse noted a change in EKG trace on the monitor. Patient is sleeping without any complaints.

Questions:

1) Describe the most significant change between the two EKGs.

2) What are the possible reasons for change?
3) How would you proceed further?

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Click on the image to enlarge.

EKG 1: Recorded at 12:44 Hrs

EKG 2: Recorded at 22:44 Hrs. 

Quiz #3: Surgical anatomy - Arrangement of Atrial Appendages

In figure 1, the arrows point to atrial appendages. What is the name for this arrangement of atrial appendages? What lesions are associated with this atrial arrangement?

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Quiz #1: What is the surgery(surgeries) shown in this image?

Front cover of January 2012 issue:
1) What surgery (surgeries are shown in this image?
2) Name the components of the surgery(surgeries) shown in the image.

Please leave your answers in comments section. Answer will be posted in approx. 7-10 days.

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