Tag Archives: EKG

Understanding ECG Filtering

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A common problem in ECG interpretation is the removal of unwanted artifact and noise. To help with this our cardiac monitors provide a means to¬†filter¬†the ECG recording. Most cardiac monitors will choose the appropriate filter based on the situation. When performing routine monitoring, where only the cardiac rhythm is important, the filters applied are known […]

65 year old male CC: Fall with injury – Conclusion

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This is the conclusion to 65 year old male CC: Fall with injury. You may wish to review the history and clinical presentation. When we left off the patient was in severe heart failure with the following 12-lead ECG. As we have mentioned before on several occasions, the most important thing when treating a patient […]

Comparing 12-Leads: Discussion

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This is the discussion for Comparing 12-Leads: Common Error or Common Disease? All of our readers were on the right track, and many were spot on! Sometimes, troubleshooting an ECG is more than just lead placement. In this case report, we had three 12-Lead ECG's, all featuring a similar pattern: inappropriate R-wave progression. Initially, when […]

88 year old male CC: Chest pain – Conclusion

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This is the conclusion to 88 year old male CC: Chest pain. You may wish to go back and review the history and clinical presentation. First, let's look at the rhythm strip. This shows an undetermined regular rhythm at a rate of about 60 with demand ventricular pacing.  This is an oversimplification but as long […]

88 year old male CC: Chest pain

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EMS is called to a 88 year old male with a chief complaint of chest discomfort. On arrival the patient meets EMS at the front door. His skin is slightly pale and moist. He appears anxious. Past medical history: "Cardiac", pacemaker, hypertension, dyslipidemia Medications: Numerous, unavailable at the time of EMS evaluation Paramedics lead the […]

64 year old female CC: Trouble Breathing

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Thanks go to Michael Herbert for this great case! As always, some details have been changed to protect patient privacy. It’s late into your shift when the tones go off for breathing problems at a local extended care facility.†Enroute you’re advised it is a 64 year old female with a “low O2 sat,” and to, […]

90 year old male CC: "Possible stroke"

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EMS responds to a 90 year old male with a "possible stroke". On arrival the patient is found sitting on the toilet (lid down). His spouse states that he had walked outside to retrieve the newpaper when he lost his balance and skinned his knee. She helped him inside and sat him down on the […]

83 year old male CC: "Cardiac patient in distress"

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EMS is dispatched to a "cardiac patient in distress". On arrival paramedics are led to the bathroom where the patient is found sitting on a foot stool. He is conscious but appears acutely ill. Skin is pale and he is slumped over. He states that he feels weak. Past medical history: High blood pressure, high […]

Conclusion to 88 year old male CC: Chest pain

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This is the conclusion to 88 year old male CC: Chest pain. You may wish to review the previous post for the history and clinical presentation. Let's take another look at the 12-lead ECG. Now with the computerized interpretation. This 12-lead ECG shows bifascicular block and is very suspicious for acute STEMI. The first thing […]

88 year old male CC: Chest pain

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EMS is called to the residence of a 88 year old male patient with a chief complaint of chest pain. On arrival the patient is found standing at the front door. He appears anxious and acutely ill. Skin is pink and warm but diaphoretic. The patient is led to a kitchen chair and the assessment […]

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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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