01-14-2014, 22:55
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#1
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Area Commander
Join Date: Feb 2004
Location: The Black Hills of SD
Posts: 5,944
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EKG/ECG Practice
Trapper John had mentioned in another thread about putting up some more EKG/ECG strips.
So let's start with this one ....
Here is the ECG from our 63 yo F patient complaining of neck and arm pain... BEFORE you jump in and write STEMI (that is too obvious), I want to know what you think the RHYTHM is.
I'm NOT going to give you Pt. Hx or scenario, just read the rhythm and give me your interpretation.
Be as precise and specific as possible.
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Sdiver is offline
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01-15-2014, 06:07
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#2
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Quiet Professional
Join Date: Mar 2012
Location: Occupied Northlandia
Posts: 1,697
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Took me a few minutes to realize what a STEMI is. It's been about 7 years since I looked at a strip so it seems they have some new terms like ST elevated myocardial infarction. We called it the "tombstone" sign.
As I had taken 12 leads for guys physicals, we never had to learn how to read them and sometimes doctors would give us classes on them. I never could remember which angle I was looking at, so never really got the feel for reading the 12 lead.
That said, the only other thing I was seeing was the pr interval seems a bit long. 1st degree AV block?
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"The rifle itself has no moral stature, since it has no will of its own. Naturally, it may be used by evil men for evil purposes, but there are more good men than evil, and while the latter cannot be persuaded to the path of righteousness by propaganda, they can certainly be corrected by good men with rifles." — Jeff Cooper
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miclo18d is offline
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01-15-2014, 06:58
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#3
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Area Commander
Join Date: Oct 2009
Location: Northeast Utah
Posts: 1,712
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Quote:
Originally Posted by miclo18d
That said, the only other thing I was seeing was the pr interval seems a bit long. 1st degree AV block?
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I agree with that assessment - the PR interval appears long but fixed, without any dropped p waves.
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"The dignity of man is not shattered in a single blow, but slowly softened, bent, and eventually neutered. Men are seldom forced to act, but are constantly restrained from acting. Such power does not destroy outright, but prevents genuine existence. It does not tyrannize immediately, but it dampens, weakens, and ultimately suffocates, until the entire population is reduced to nothing better than a flock of timid, uninspired animals, of which the government is shepherd." - Alexis de Tocqueville
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PedOncoDoc is offline
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01-15-2014, 08:15
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#4
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Quiet Professional
Join Date: Nov 2012
Location: Harrisburg, PA
Posts: 3,835
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First thing that struck me was the inverted T-wave in lead I. The second is what appears to be a broad T-wave in all leads, and elevated S-T interval (short S-T interval with a long S-T segment?) The obvious MI aside, I get the impression of a left ventricular hypertrophy too.
Is this patient on digoxin? I am thinking there may be some pharmacological induced ECG changes too, but not sure.
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Trapper John is offline
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01-15-2014, 10:21
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#5
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Area Commander
Join Date: Feb 2004
Location: The Black Hills of SD
Posts: 5,944
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Quote:
Originally Posted by Trapper John
First thing that struck me was the inverted T-wave in lead I. The second is what appears to be a broad T-wave in all leads, and elevated S-T interval (short S-T interval with a long S-T segment?) The obvious MI aside, I get the impression of a left ventricular hypertrophy too.
Is this patient on digoxin? I am thinking there may be some pharmacological induced ECG changes too, but not sure.
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In this thread, don't worry about meds or Hx or Dx, just give me your interpretation of the posted strip.
Remember, be as precise and specific as possible in reading it off. 
__________________
Non Sibi Sed Suis
_____________________________________________
It's Good To Be Da King !!!! Just ask NDD !!!!
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Sdiver is offline
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01-15-2014, 12:50
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#6
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Quiet Professional
Join Date: Nov 2012
Location: Harrisburg, PA
Posts: 3,835
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Quote:
Originally Posted by Sdiver
In this thread, don't worry about meds or Hx or Dx, just give me your interpretation of the posted strip.
Remember, be as precise and specific as possible in reading it off. |
FTFSI  Just couldn't help myself
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Trapper John is offline
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