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Blog postThe 2-lead rhythm strip shown in Figure-1 was obtained from a young adult woman who presented for "palpitatons". No known previous history of heart disease.
How would YOU interpret this tracing?Given the above history — What are your clinical considerations?
Figure-1: 2-lead rhythm strip obtained from a young adult woman with "palpitations" (See text).
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NOTE #1 -
Blog postThe ECG shown in Figure-1 was obtained from an older woman found to have a slow pulse.
Can you explain the rhythm?
Figure-1: ECG obtained from an older woman with a slow pulse.
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NOTE: Some readers may prefer at this point to listen to the 6:15-minute ECG Audio PEARL before reading My Thoughts regarding the ECG in -
Blog postThe ECG shown in Figure-1 was obtained from a young adult who presented with a presyncopal episode.
What is the cause of the AV dissociation?
Figure-1: ECG from a young adult who presented with a presyncopal episode.
My Initial Thoughts on Seeing this Tracing:
When I first saw this ECG — my "eye" was immediately drawn to the deflections that I highlight with B -
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Blog postThe ECG in Figure-1 was obtained from a 30-ish year old man with a history of a bicuspid aortic valve. He presented to the ED (Emergency Department) for a pre-syncopal episode.
QUESTION:
Is this Wellens' Syndrome?
Figure-1: ECG obtained from a 30-ish year old man who presented to the ED for pre-syncope. Is this Wellens' Syndrome?
— The Case Continues BELOW toda -
Blog postThe 2 tracings that are shown in Figure-1 and Figure-2 were obtained during and shortly after a screening ETT ( = Exercise Treadmill Test).
QUESTIONS:
Are the earlier-than-expected wide beats in both tracings PVCs (Premature Ventricular Contractions) or PACs (Premature Atrial Contractions) with aberrant conduction?What are the clinical implications of these early wide beats?
Figure-1: 12-lead ECG and dual-lead rhyt -
Blog postThe ECG in Figure-1 was obtained from a middle-aged patient who was thought to have advanced AV block.
QUESTION:
Is the rhythm Mobitz I? — Mobitz II? — or not?
Figure-1: 12-lead ECG and long lead II rhythm strip from a patient thought to be in AV block (See text).
— The Case Continues BELOW today's Audio Pearl ... —
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Blog postThe ECG in Figure-1 was obtained from an 85-year old man who presented with "dizziness".
QUESTION:
Can you explain what is happening with each beat on this tracing?
Figure-1: 12-lead ECG and long lead II rhythm strip from a 85-yo man with dizziness (See text).
My Sequential Approach to Today's Case: This is indeed a challenging traci -
Blog postThe ECG in Figure-1 was obtained from a previously healthy 60-year old man who presented to the ED (Emergency Department) with palpitations and new chest pain.
QUESTIONS:
Should you activate the cath lab?What would you do first?
Figure-1: ECG from a 60-yo man with palpitations and chest pain.
My Approach to Today's Case: We are told that the patient in today -
Blog postThe 2 ECGs shown in Figure-1 were obtained from the same patient just 20 minutes apart. This 40-year old man had a long history of alcohol abuse — and was admitted for advanced cirrhosis with ascites. He was on a number of medications — and reportedly had reduced oral intake with decreased urine output in recent days.
ECG #1 was obtained because of chest discomfort and palpitations — but the patient was alert and hemodynamically stable the entire time t -
Blog postThe 2 ECGs shown in Figure-1 are both of patients from India, who share a similar pathologic process. Describe the valvular pathology they share. Be as specific as possible!
Extra Credit:
What additional information does the QRS morphology in lead V1 suggest?
Figure-1: ECGs of 2 patients from India who share a similar pathology. Can you guess the valvular pathology that they share?
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Blog postThe ECG in Figure-1 was obtained as part of a routine exam of an otherwise healthy and asymptomatic 30-year old man.
QUESTIONS:
What are the abnormal findings in Figure-1?Are any of the P waves conducted to the ventricles?Clinically — HOW should this patient be treated?
Figure-1: ECG obtained from an otherwise healthy and asymptomatic 30-year old man. Can you explain the abnormal findings?
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Blog postImagine that the ECG in Figure-1 was obtained from an older patient with epigastric discomfort and "heartburn". No prior tracing is available for comparison.
QUESTIONS:
How would you interpret the ECG in Figure-1?Where is the problem?
Figure-1: ECG obtained from an older patient with epigastric discomfort and "heartburn". WHERE is the problem?
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Blog postThe ECG in Figure-1 was obtained from a 65-year old man with longstanding hypertension. He presented to the ED (Emergency Department) with an exacerbation of HF (Heart Failure). No chest pain. No prior tracing was available.
QUESTIONS:
Is there evidence of MI (Myocardial Infarction) in Figure-1?IF so — Are you concerned about a "new" or "old" MI?
Figure-1: ECG obtained from a 65-year old man with hyperten -
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Please NOTE: There will be no new ECG Blog posts for a while ...
All material on this ECG Blog site remains open!
The INDEX tab in the upper right of each page has linked Contents, listed by subject.IF you scroll down a little on the right-hand column of this blog — You'll see an icon for "ECG Audio PEARLS". This link takes you to 45 Audio Pearls, all of which are recent -
Blog postToday's case is about the interpretation of the 2-lead rhythm strip that is shown in Figure-1. There is no clinical information.
WHY is there group beating?Is there AV block?
Figure-1: How would you interpret this 2-lead rhythm strip? (NOTE: Since the ECG grid is faded — I have drawn in the size of 2 large boxes in between beats #4-5).
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NOTE: Some readers may -
Blog postThe 12-lead ECG and long lead II rhythm strip shown in Figure-1 was obtained from a woman in her 60s, who was attended to by EMS (Emergency Medical Services) for chest pain and palpitations. She was hemodynamically stable at the time the ECG and rhythm strip in Figure-1 were obtained.
QUESTIONS:
How would you interpret the tracings in Figure-1? Should the cath lab be activated?What is the rhythm? Is a pacemaker likely -
Blog postThe 12-lead ECG and long lead II rhythm strip shown in Figure-1 was obtained from a man in his 60s who presented with a complicated course, including high fever and chest pain. The patient was unresponsive without a pulse on arrival in the ED (Emergency Department) — but promptly responded to resuscitation (albeit with hypotension) — at which time ECG #1 was obtained.
Unfortunately — details of this patient's subsequent course were not available to me. That -
Blog postToday's blog is all about the Regular SVT (SupraVentricular Tachycardia). The patient whose ECG is shown in Figure-1 presented with "palpitations". He was hemodynamically stable.
How would you interpret the ECG in Figure-1?And — Can you tell the mechanism of this rhythm?P.S. — How many of the 8 PEARLS that I list below were you aware of?
Figure-1: How would you interpret this ECG? (See text).
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Blog postToday's case is a fascinating ECG, albeit without clinical information (Figure-1).
How would you interpret the ECG in Figure-1?And — WHY are there 2 kinds of P waves?
Figure-1: How would you interpret this 2-lead rhythm strip? (See text).
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NOTE: Some readers may prefer at this point to listen to the 5:00-minute ECG Audio PEARL&nbs -
Blog postThe ECG shown in Figure-1 was obtained from an elderly woman, who presented to the ED (Emergency Department) with an acute febrile illness (40°C).
How would you interpret her initial ECG?Clinically — Could this be an early acute antero-septal STEMI?
Figure-1: ECG obtained from an elderly woman with an acute febrile illness (See text).
The Case Continues:
The ECG was repeated (Figure-2) -
Blog postThe ECG shown in Figure-1 was obtained from a patient in his 70s — who presented to the ED (Emergency Department) with dizziness.
How would you interpret this ECG?And — Is there Complete AV Block?In addition to the interesting rhythm — there are at least 4 other ECG findings that should be commented on. How many of these other findings do you recognize?
Figure-1: ECG obtained from a patient with dizziness (See text) -
Blog postMy GOAL in today's ECG Blog #236 is to clarify by means of a 15-minute ECG Video — the 2nd-Degree AV Blocks, of which there are 3 Types:Mobitz I ( = AV Wenckebach).Mobitz II.2nd-Degree AV Block with 2:1 AV conduction.
This 15-minute ECG Video (Media PEARL #52) — Reviews the 3 Types of 2nd-Degree AV Block — plus — the hard-to-define term of "high-grade" AV block. I supplement this material with the following 2 PDF handouts.Section 2F (6 pages = the &quo -
Blog postThe ECG shown in Figure-1 was obtained from a patient with dizziness.
How would you interpret this ECG?And — Is there Complete AV Block?
Figure-1: ECG obtained from a patient with dizziness (See text).
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NOTE: Some readers may prefer at this point to listen to the 8:25 minute ECG Audio PEARL before reading My Thoughts regarding -
Blog postThe ECG shown in Figure-1 was obtained from a man in his 60s, who presented to the ED (Emergency Department) with shortness of breath.
How would you interpret this ECG?Clinically — What would you say about this patient?
Figure-1: ECG obtained from a man in his 60s who presented with shortness of breath (See text).
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NOTE #1: Some readers may prefer at t -
Blog postThe ECG shown in Figure-1 was obtained from a previously healthy 70-year old man, who presented to the ED (Emergency Department) with new-onset dyspnea.
Does the anterior T wave inversion represent acute ischemia from Wellens’ Syndrome?If not — What is YOUR diagnosis?
Figure-1: ECG obtained from a previously healthy 70-year old man with new-onset dyspnea.
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NOTE #1:
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