Jump to content

Recommended Posts

  • Replies 53
  • Created
  • Last Reply

Top Posters In This Topic

Posted
If you double click on the strip it gets bigger.

If you enlarge the image when you click on the part where it says to click to enlarge and it opens a new window click and hold the control key on your keyboard and then hit the + key. It will enlarge the image even larger as many times as your click it. If you do the same, but use the - key, it will make it smaller. This also works for normal web page viewing. It works in firefox, and internet explorer.

Posted

Thanks to all that replied with their impressions.

The next strip tease will be on the way shortly!!

  • 2 months later...
Posted
PACER-1.jpg

12-Lead should be redone, aVR should not be upright.

I see Sinus with Pacer.

  • 3 weeks later...
Posted

Why do you think it is upright? What could cause this? Pushing the 12-lead button again won't change it's polarity.

Posted

The negative deflections point me to some form of bundle branch block meaning the electrical impulse is travelling in a different direction than towards the positive lead (creating positive deflection).

I am also seeing some ST elevation in II, III, aVR, aVF

Posted
The negative deflections point me to some form of bundle branch block meaning the electrical impulse is travelling in a different direction than towards the positive lead (creating positive deflection).

I am also seeing some ST elevation in II, III, aVR, aVF

Did you not read the preceding posts before reviving this dead post? It is a paced rhythm and thus you can make NO conclusions about ST segment - abnormal depolarization means abnormal repolarization - Look at V4, V5 for the spikes.

Posted
Did you not read the preceding posts before reviving this dead post? It is a paced rhythm and thus you can make NO conclusions about ST segment - abnormal depolarization means abnormal repolarization - Look at V4, V5 for the spikes.

That's not entirely true. You just have to understand the expected appearance of the ST segments and T waves in the context of paced rhythm (which is similar to that of LBBB). In the presence of paced rhythm, the ST segment and T wave should be deflected opposite the main vector of the QRS complex (which is also the terminal deflection). The concept is "appropriate ST segment and T wave discordance". Any ST segment elevation in a lead with an upright QRS complex is abnormal. In a lead with a negative QRS complex, the deeper the S wave, the higher the ST segment elevation (normal finding with paced/LBBB). When the ST elevation is greater than 0.25 the QRS complex, it's abnormal and usually indicates AMI. ST depression is a lead that shows a negative QRS complex is also abnormal and often indicates AMI (inappropriately concordant ST segment depression).

Tom

Posted (edited)

I really don't believe that without previous 12 leads on this patient that you can make any determination as to what is "normal" for this patient and what is elevation. I appreciate your obvious knowledge re: 12 lead interpretation but my statements are directly related to what I can and cannot do in the field. If I was in the hospital setting with history on this patient, then I guess I would learn this cool stuff.

The same goes for LBBB. 12 lead interpretation stops. That does not mean that I don't treat the patient. Signs and symptoms of acute cardiac will be treated per protocol. I just wouldn't make any statements of ST elevations, etc.

Edited by Kaisu

×
×
  • Create New...