tag:blogger.com,1999:blog-3364570834099131201.post1845081751848231940..comments2024-03-23T08:57:50.965-04:00Comments on ECG Interpretation: ECG Blog #145 – (ST Depression – STEMI – BBB)ECG Interpretationhttp://www.blogger.com/profile/02309020028961384995noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-3364570834099131201.post-62268374513105764822020-01-21T09:04:39.183-05:002020-01-21T09:04:39.183-05:00Thanks for your comment! There was no pulmonary em...Thanks for your comment! There was no pulmonary embolism. As I note above — cath revealed very severe 3-vessel disease.ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-3364570834099131201.post-20524171316655942072019-04-28T06:13:47.572-04:002019-04-28T06:13:47.572-04:00Excuse me Sir.
I think the ECG showed "right ...Excuse me Sir.<br />I think the ECG showed "right heart strain" picture with right axis deviation, RBBB, and sinus tachycardia. So can I think the patient got pulomonary embolism?<br />Thank you for your amazing lecture, Sir.Nguyễn Hoàng Hânhttps://www.blogger.com/profile/06071458499073090521noreply@blogger.comtag:blogger.com,1999:blog-3364570834099131201.post-70757439935791593452018-01-06T05:35:49.723-05:002018-01-06T05:35:49.723-05:00Yes, thank you sir!Yes, thank you sir!Nguyen Chí Tínhhttps://www.blogger.com/profile/10755092672681857950noreply@blogger.comtag:blogger.com,1999:blog-3364570834099131201.post-83223803895485490652018-01-06T03:21:24.678-05:002018-01-06T03:21:24.678-05:00This case was sent to me, so I do not have many de...This case was sent to me, so I do not have many details — but the chest pain was new — the cath showed very severe multi-vessel coronary disease — and the ST-T wave changes are profound — so this was clearly an acute coronary syndrome on a background of severe multi-vessel disease in need of acute attention. Thanks for your comment!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-3364570834099131201.post-52337422929324699422018-01-05T21:55:49.368-05:002018-01-05T21:55:49.368-05:00Thanks sir for your interesting writing, very info...Thanks sir for your interesting writing, very informative and many teaching points. Obviously, the patient had chest pain, sinus tachycardia, ST-T changes which are all suggestive of acute coronary syndrome. So, how were the cardiac enzymes sir, were they elevated? And Did the coronary angiography show thrombus sir? I just want to be clear if this was a case of ACS or chronic severe 3- vessel disease, sir. Thank you sir!Nguyen Chí Tínhhttps://www.blogger.com/profile/10755092672681857950noreply@blogger.comtag:blogger.com,1999:blog-3364570834099131201.post-86964315684129784232018-01-05T11:42:11.614-05:002018-01-05T11:42:11.614-05:00Fantastic description on one of the several uses o...Fantastic description on one of the several uses of caliper! Thanks!Mario Parrinellohttps://www.blogger.com/profile/07136945770330333718noreply@blogger.comtag:blogger.com,1999:blog-3364570834099131201.post-23216318794853270642018-01-04T23:47:11.968-05:002018-01-04T23:47:11.968-05:00Thanks for the kind words Mario. Measuring with ca...Thanks for the kind words Mario. Measuring with calipers IS indeed tricky. When looking for extra P waves (with 2:1 conduction) — I make sure that my calipers are set to PRECISELY one half of the R-R interval. Then I look in ALL 12 leads on the tracing. Almost always when I do this — I AM able to pick up extra P waves if they are present. I'm about 90-95% sure that we don't have 2:1 conduction in this case — but I am not yet certain ... All I'm saying is that this is one that I'd assume probable sinus rhythm — but I'd keep open the possibility that there could be hidden P waves. I'm CERTAIN that if I was at the bedside — that monitoring over ensuing minutes would tell me if there are or are not extra P waves. All that said — the important clinical point here is that for initial management decision making in this case — it really does not matter if there are or are not extra P waves — because prompt cath is the first priority ... THANKS again for your comment!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-3364570834099131201.post-61650555470824409602018-01-04T11:50:16.197-05:002018-01-04T11:50:16.197-05:00The deflections perhaps suggesting another P' ...The deflections perhaps suggesting another P' can be easily overlooked, thanks for uderlining this point; on the other hand measuring with caliper the exact onset of those extra P waves is rather tricky. But of course there are other priorities here. Thanks again for your invaluable teaching!Mario Parrinellohttps://www.blogger.com/profile/07136945770330333718noreply@blogger.com