Tag Archives: bundle branch block

58 year old male CC: Chest pain

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Here’s an interesting case sent in by a faithful reader who wishes to remain anonymous. EMS is called to the residence of a 58 year old male complaining of chest discomfort. On arrival the patient is found sitting on the edge of the bed. He is anxious but alert and oriented to person, place, time, […]

Identifying STEMI in the presence of LBBB – Sgarbossa's Criteria – Part I

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There has been a lot of discussion lately about identifying AMI in the presence of LBBB (see Dr. Bearemy’s “My Emergency Medicine Blog” here and a recent thread on the EKG Club). I’ve also been receiving a lot of emails offlist, so I think a full discussion is in order. In my recent post Who […]

Computerized interpretive statements and bundle branch blocks

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Here’s an ECG that I’ve used in my 12 lead class for many years. It’s usually good for a laugh! I show this ECG right after I teach students to identify LBBB on the 12 lead ECG. I explain that it was captured on an emergency call for a 80 year old male who was […]

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Comments
Vince DiGiulio
The 360 Degree Heart – Part II
It is standard practice in electrocardiography to label the first 90 degrees counter-clockwise from "zero" that way. When you see a patient with "left axis deviation" you'll see that their measured QRS axis is somewhere between -30 and -90 degrees. Imagine if you saw someone with a mean QRS axis at 5 degrees. Now imagine…
2014-10-21 14:00:37
Bryan
The 360 Degree Heart – Part II
I don't understand why (-)III and aVL are be labeled -60 and -30 degrees instead of 300 and 330 degrees?
2014-10-21 13:43:29
The 360 Degree Heart – Part II | EMS 12 Lead
The 360 Degree Heart – Part I
[…] first post in our “360 Degree Heart” series attempted to visualize how the different frontal plane […]
2014-10-21 12:50:56
Eric Strong
Axis Determination – Part VI
This is a great discussion of axis determination. One minor suggestion: I think it's potentially misleading to refer to an axis between 0 and -30 as "physiologic left axis deviation", since "axis devitation" implies deviation from normal, and axes between 0 and -30 are perfectly normal, (depending on age and body habitus). It may be…
2014-10-05 17:09:00
Ian
Right ventricular infarction – Part I
Can you give me a little more info on hypervagotonia? I googled around for some info but there doesn't seem to be much info and it's a term I've never heard before. Thanks!
2014-10-05 15:09:24

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