Tag Archives: ECG

Found on the LIFENET 05/2011

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Found on the LIFENET. What is your impression of this ECG?   *** UPDATE *** Consider this recent case from Dr. Smith's ECG Blog. ST-elevation in aVR, with widespread ST-depression "ST elevation in aVR is often thought to represent left main occlusion. However, it really just signifies widespread and diffuse subendocardial ischemia which could be […]

82 year old male CC: Shortness of breath – Conclusion

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This is the conclusion to 82 year old male CC: Shortness of breath. Let's take another look at the 12-lead ECG. This ECG shows a severe bradycardia. We need to ask a couple of very important questions. Is the patient stable or unstable? The patient is unstable. In fact, the patient is periarrest. We cannot […]

82 year old male CC: Shortness of breath

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Here's an interesting and somewhat unusual case submitted by a faithful reader who wishes to remain anonymous. EMS is called to the residence of a 82 year old male complaining of shortness of breath and weakness. On arrival the patient is found slumped sideways in a chair. He is weak and in significant distress, repeating, […]

88 year old female CC: Chest pain

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Here’s a really interesting ECG submitted by my good friend David Hildebrandt. EMS is called to an assisted living facility for an 88 year old female who is weak and complaining of chest pain. The patient is found lying on her side in bed. She appears acutely ill and states she is nauseated. She is […]

49 year old male CC: Chest pain

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From the archives. EMS is called to the vacation residence of a 49 year old male complaining of chest pain. On arrival the patient is found sitting at the kitchen table. He appears anxious and acutely ill. Past medical history: Healthy Meds: None Allergies: NKDA Skin is cool, pale and diaphoretic. He confirms that he […]

74 year old female CC: Chest pain

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Is there anything else you’d like to know about this patient?

50 year old male CC: Chest pain

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Here’s a really interesting case submitted by “Anonymous from Ann Arbor, Michigan.” Wolverines! Sorry, Buckeyes. EMS is called to the residence of a 59 year old male with a chief complaint of chest pain. Past medical history: Dyslipidemia Meds: Zocor The patient was given 600 mg ASA by the spouse prior to EMS arrival. Onset: […]

85 year old female CC: Respiratory distress – Discussion

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This is the follow-up and discussion for 85 year old female CC: Respiratory distress. As usual, thank you for all the insightful comments! The case demonstrates some very important points not the least of which is that the differential diagnosis of shortness of breath can be difficult, even for emergency physicians who have access to […]

85 year old female CC: Respiratory distress

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EMS is called to a local nursing home for a 85 year old female with a chief complaint of respiratory distress. On arrival the patient is found lying in bed in obvious distress. Respirations are 40 and shallow with a prolonged expiratory phase and accessory muscle usage. Auscultation of the chest reveals a poor tidal […]

78 year old male CC: Dizziness – Conclusion

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There were so many great comments on this case, including some great discussion on classifying wide complex tachycardias!

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
David Baumrind
All that wiggles isn’t Wellens’
@Gary, by all means, nitpick all you like. I agree with your assessment, and the post has been modified. Thank you for the feedback!
2014-08-30 17:28:16
Gary Huntress
All that wiggles isn’t Wellens’
Not to nitpick but is this really a "slightly leftward axis"? I and AVF are both positive. I put it at about +20 degrees, not leftward.
2014-08-30 11:49:35
Handsome Robb
87 YOM COMPLAINING OF CHEST DISCOMFORT AND DYSPNEA
CHF. 12-lead shows a sinus Tachycardia in the 120s with PACs, besides the anterior leads there's diffuse ST depression, the STE in the anterior leads can be explained by the LBBB, axis is good as well. I wish they posted the EtCO2 waveform so we could see but I'm assuming it's non-obstructive. The elevated EtCO2…
2014-08-30 08:08:22
Christopher Watford
“Bad heartburn” – 82 y.o. female without chest pain.
Brooks, Firstly, thank you for the warm welcome to the club. Secondly, the Glasgow algorithm's only published sens/spec for AMI is 51.6%/97.6% respectively (Tuscon STEMI Database). I've not been able to find any other publications. The GE Marquette 12SL algorithm has been widely studied, but is much older, and ranges in sensitivity from 48% to…
2014-08-29 16:50:14
CB
57 Year Old Male–Chest Discomfort
Given what he was doing (paint fumes on ladder painting) I would first question if the pain is reproducable. Yes his ekg isn't normal but looks like old inferior MI. And he is hypertensive. 02 a must. Def. would give ASA. First would give morphine and see how his cp and bp are. If still…
2014-08-29 11:37:25

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