Wednesday, September 23, 2015

ECG Blog #118 (ECG Video-15) — QRST Changes (Applying a Systematic Approach)

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This is the 15th installment of my ECG Video Blog. This 65-minute video reviews QRST Changes (and Applying a Systematic Approach). There is a LOT of material in this video — so you may want to view it in more than a single session. Click on the link below for a detailed linked CONTENTS (so that you can easily navigate through the video).

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NOTE: There are advantages to using a video format format. These include:
  • Ability to illustrate concepts not done full justice by the written word.
  • Greater dispersion of my content through Google & YouTube. This material is free for anyone to use.
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LINKS to my ECG Video-Blog installments:
  • ECG Video-Blog #1-Revised (= Blog #95) — Is there AV Block?
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  • ECG Video-Blog #2 (= Blog #96) — Bundle Branch Blocks
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  • ECG Video-Blog #3 (= Blog #97) — SVT with marked ST Depression
  • ------------------------------------------------------------
  • ECG Video-Blog #4 (= Blog #98) — Clinical Arrhythmia Mgmt (Part I )
  • ECG Video-Blog #5 (Blog #99) — Clinical Arrhythmia Mgmt (Part 2 )
  • ECG Video-Blog #6 (= Blog #100) — Clinical Arrhythmia Mgmt (Part 3 )
  • ------------------------------------------------------------
  • ECG Video-Blog #7 (= Blog #101) — Wide Tachycardia + Chest Pain
  • ------------------------------------------------------------
  • ECG Video-Blog #8 ( = Blog #105) — Basics of AV Block
  • ECG Video-Blog #9 ( = Blog #110) — Complete AV Block? / Laddergrams
  • ------------------------------------------------------------
  • ECG Video-Blogs #10,11,12 ( Blog #113) — Rhythm Diagnosis Basics
  • ------------------------------------------------------------
  • ECG Video-Blog #13 ( = Blog #116) — Essentials of Axis / Hemiblocks
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  • ECG Video-Blog #14 ( = Blog #117) — Brugada Syndrome
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  • ECG Video-Blog #15 ( = Blog #118) — QRST Changes
  •    Easy YouTube Link for AV Block (www.QRSTecg.com)
  •    Click Here for Timed Contents to the QRST Changes Video!
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  • ECG Video-Blog #16 ( = Blog #120) — Giant T Waves
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         This is the 15th installment of my ECG Video Blog (www.QRSTecg.com). This video is 65 minutes long — so you may want to view it in more than a single session. If you click on the description just below the Video on YouTube – you’ll see a detailed linked CONTENTS, so that you can easily navigate through the video. There are 3 main parts: i) Initial thoughts on the use of a Systematic Approach to ECG Interpretation; ii) Detailed discussion on how to assess for QRST Changes (assessing Q waves; R wave progression/Transition; ST-T wave changes); and iii) Practice Tracings that put concepts presented in the first 47 minutes of the video together. 
    • NOTE: I aimed my content at an Intermediate level interpreter (with emphasis on BASIC concepts plus LOTS of PEARLS for more advanced interpreters along the way). 
    Hope you enjoy this! I welcome your feedback! (Ken Grauer, MDekgpress@mac.com).
      Figure-1: Schematic Figure from this video on QRST Changes (CLICK HERE to Fast Forward to 31:10 in the video where use of the PR & TP segment baselines is discussed). One could use either the PR or TP Baseline for assessing ST-T wave deviations. We often use a combination of both (depending on specifics for the tracing at hand). Below in the Figure we illustrate 1-2mm of ST depression (left) — and 2-3mm of ST elevation (right). NOTE — Enlarge by clicking on Figures — Right-Click to open in a separate window.
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      GT—  https://youtu.be/vRgnVuRmiyI — on YouTube to view this ECG Video (29 minutes). The "Easy" Link = www.QRSTecg.com -
      • Click Here  — for a Timed CONTENTS of Video-Blog #15 on QRST Changes.
      • Please also see our ECG Blog #94 ( = Basic ECG Concepts #7 on QRST Changes).
      • Please also check out my ECG Video Blog page on Google. The link is easy to remember = www.videoecg.com -
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      NOTE: For a Power Point Show (.ppsx) version of my Video Blogs - CLICK HERE. This folder will contain links to download a .ppsx version that allows faster viewing:
        • Download the .ppsx to your computer desktop.
        • The PPT show is without automatic sound. YOU activate only the Audio clips you want.
        • Hover your mouse over the highlighted Audio. You may play and/or pause if/as you like.
        • Feel free to use this .ppsx for teaching with my blessings!
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        Monday, September 7, 2015

        ECG Blog #117 (ECG Video-14) — Brugada Syndrome


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        This is the 14th installment of my ECG Video Blog. This 29-minute video reviews Recognition of Type-1 and Type-2 (Saddleback) Brugada ECG Patterns, with essentials of management for the non-cardiologist. There is focus on distinction from the right bundle branch block and normal variant patterns, with suggestions on when to refer.
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        NOTE: There are advantages to using a video format format. These include:
        • Ability to illustrate concepts not done full justice by the written word.
        • Greater dispersion of my content through Google & YouTube. This material is free for anyone to use.
        -----------------------------------------
        LINKS to my ECG Video-Blog installments:
        • ECG Video-Blog #1-Revised (= Blog #95) — Is there AV Block?
        • ------------------------------------------------------------
        • ECG Video-Blog #2 (= Blog #96) — Bundle Branch Blocks
        • ------------------------------------------------------------
        • ECG Video-Blog #3 (= Blog #97) — SVT with marked ST Depression
        • ------------------------------------------------------------
        • ECG Video-Blog #4 (= Blog #98) — Clinical Arrhythmia Mgmt (Part I )
        • ECG Video-Blog #5 (Blog #99) — Clinical Arrhythmia Mgmt (Part 2 )
        • ECG Video-Blog #6 (= Blog #100) — Clinical Arrhythmia Mgmt (Part 3 )
        • ------------------------------------------------------------
        • ECG Video-Blog #7 (= Blog #101) — Wide Tachycardia + Chest Pain
        • ------------------------------------------------------------
        • ECG Video-Blog #8 ( = Blog #105) — Basics of AV Block
        • ECG Video-Blog #9 ( = Blog #110) — Complete AV Block? / Laddergrams
        • ------------------------------------------------------------
        • ECG Video-Blogs #10,11,12 ( Blog #113) — Rhythm Diagnosis Basics
        • ------------------------------------------------------------
        • ECG Video-Blog #13 ( = Blog #116) — Essentials of Axis / Hemiblocks
        • ------------------------------------------------------------
        • ECG Video-Blog #14 ( = Blog #117) — Brugada Syndrome
        •    Easy YouTube Link for AV Block (www.brugadaecg.com)
        •    Click Here for Timed Contents to the Brugada Syndrome Video!
        • -----------------------------------------------------------
        • ECG Video-Blog #15 ( = Blog #118) — QRST Changes
        • -----------------------------------------------------------
        • ECG Video-Blog #16 ( = Blog #120) — Giant T Waves
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               My goal in this 29-minute video is to simplify recognition of Brugada ECG Patterns (Type-1 and Type-2) in a user-friendly approach based on current literature. 
          • Key Points for recognition of Brugada-1 and Brugada-2 ECG Patterns are shown in Figure-1 below — taken from our Video discussion. (These points are summarized at Minute 19:15 in the Video).
            Figure-1: 12-lead ECG from an asymptomatic young adult who had this tracing done as part of a sports pre-participation exam. Should the patient be cleared to participate in vigorous athletic activity? Or — Is there a Brugada-1 pattern in lead V1 and/or a Brugada-2 (Saddleback) pattern in lead V2Schematic illustrations below highlight key recognition points for Brugada-1 Pattern (downsloping ST segment still elevated above baseline at 80 msec. after the r' peak)andBrugada-2 Pattern (wide ß-angle, as defined by a triangle base of ≥4 mm after dropping a 5mm vertical line from the r' peak — and after following the slope of the downsloping ST segment after the r' wave). NOTE — Enlarge by clicking on Figures — Right-Click to open in a separate window.
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            GTO — https://youtu.be/h1MhtLMF-7M — on YouTube to view this ECG Video (29 minutes). The "Easy" Link = www.brugadaecg.com -
            • Click Here  — for a Timed CONTENTS of Video-Blog #14 on Brugada Syndrome.
            • Please also see our ECG Blog #50  and the pdf from Section 05.33 (from our ECG-2014-ePub) — for more on Brugada Syndrome.
            • Please also check out my ECG Video Blog page on Google. The link is easy to remember = www.videoecg.com -
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            NOTE: For a Power Point Show (.ppsx) version of my Video Blogs - CLICK HERE. This folder will contain links to download a .ppsx version that allows faster viewing:
              • Download the .ppsx to your computer desktop.
              • The PPT show is without automatic sound. YOU activate only the Audio clips you want.
              • Hover your mouse over the highlighted Audio. You may play and/or pause if/as you like.
              • Feel free to use this .ppsx for teaching with my blessings!
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