ECG Blog #103 (My ECG Guru Comments-1) - Acute MI Tracings

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As a source of tracings for practice and/or teaching — I have decided to LINK many of the ECGs I have commented on as Contributing Expert for ECG Guru (www.ecgguru.com). 

• NOTE: The ECG Guru is dedicated to providing free resources for ECG Teachers and their Students. Search the ECG Guru site if you ever are in need of cases on a particular subject.

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Regarding My Comments on the ECG Guru:

• ECG Blog #103 — Acute MI ECGs (Comments #848; 838; 823; 819; 801 ).
• ECG Blog #104 (Comments #828; 836) — AV Blocks/AV Dissociation.
•    ECG Blog #105 — AV Block Basics Video (www.avblockecg.com).
• ECG Blog #123 — LINKS to My ECG Guru Posts (Volume-1).
• ECG Blog #124 — Using a Normal ECG for Teaching (ECG Guru).

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ECG for Comment #848 — on the ECG Guru (Instructor Collection — posted 1/16/2015):

This ECG was obtained from a patient presenting to the ED (Emergency Department) with new-onset chest pain. Unfortunately — No follow-up is available ...

• How would you interpret this ECG — given that the patient has new-onset chest pain?
• What is the "culprit" artery likely to be?

Figure-1: ECG obtained from a patient with new-onset chest pain.

• For My Interpretation — See ECG Guru Comment-848.

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ECG for Comment #838 — on the ECG Guru (Instructor Collection — posted 11/16/2014):

This ECG was obtained from a patient with chest pain. Unfortunately — additional details are not available ...

• How would you interpret this ECG — given the not unexpected history of chest pain?
• What is the "culprit" artery likely to be?
• Do the ECG findings shown here suggest LMain "disease"?

Figure-1: ECG obtained from a patient with chest pain.

• For My Interpretation — See ECG Guru Comment-838.

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ECG for Comment #823 — on the ECG Guru (Instructor Collection — posted 8/29/2014):

This ECG was obtained from an 88-year old woman who presented to the ED (Emergency Department) in cariogenic shock. She apparently had been "ill" for several days prior to arrival in the ED.

• What would you expect to find on cardiac catheterization? (Cath films are shown at the above link on ECG Guru).
• Is all that you see on her ECG likely to be new?

Figure-1: ECG obtained from an 88-year old woman who presented in cardiogenic shock. What would you expect to find on cath?

• For My Interpretation — See ECG Guru Comment-823.

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ECG for Comment #819 — on the ECG Guru (Instructor Collection — posted 11/16/2014):

This ECG was obtained from a patient found to have LMain occlusion on cath. Unfortunately — additional details are not available ...

• Interpret the ECG. How many abnormal findings can you detect?
• Comment on the cath findings.
• Can one distinguish on ECG between proximal LAD vs LMain occlusion?

Figure-1: ECG obtained from a patient with LMain occlusion. Are you surprised by this cath finding?

• For My Interpretation — See ECG Guru Comment-819.

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ECG for Comment #801 — on the ECG Guru (Instructor Collection — posted 7/5/2014):

The computer interpreted the rhythm for this tracing as, "AFib with PVCs". Unfortunately — additional details are not available ...

• Do you agree with the computerized interpretation of the rhythm?
• What else is going on?
• Which arm should you check first on the patient? (ie, What is the likely source of the artifact?).

Figure-1: ECG with lots of artifact ... Is the rhythm AFib (as the computer says)? What else is going on?

• For My Interpretation — See ECG Guru Comment-801.

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