Tag Archives: left ventricular hypertrophy

90 year old male CC: "Possible stroke" – Conclusion

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This is the conclusion to 90 year old male CC: "Possible stroke". You might want to go back and familiarize yourself with the details of the case. Let's take another look at the 12-lead ECG. Now with the computerized interpretive algorithm. On Facebook I had asked whether or not this ECG showed signs of ischemia. […]

17 year old male CC: Syncope – Discussion

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This is the discussion for 17 year old male CC: Syncope. You may wish to go back and familiarize yourself with the details of the case. Let's take another look at the 12-lead ECG. It wasn't that long ago that I was trying to convince paramedics to perform 12-lead ECGs on chest pain patients. I […]

63 year old male CC: Shortness of breath – Conclusion

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This is the conclusion to 63 year old male CC: Shortness of breath. You may wish to go back and read the original post. Let's take another look at the 12-lead ECG. Now with the computerized interpretation. This ECG shows severe left ventricular hypertrophy with a "strain pattern" or secondary ST-T wave abnormality. A "strain […]

57 year old female CC: Shortness of breath and chest pressure – Discussion

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This is the discussion for 57 year old female CC: Shortness of breath and chest pressure. Let's take another look at the 12-lead ECGs. I posed the following questions for this case: What do you think of these 12-lead ECGs? What is the most likely cause of the ST-depression and T-wave inversion. These ECGs show […]

55 year old male CC: Chest pain? – Conclusion

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This is a real challenge because it meets the voltage criteria for left ventricular hypertrophy in the limb leads.

47 year old female CC: Chest pain – Discussion

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Thanks for all the comments! I’m not allowed to blog while I’m on duty (the policy has nothing to do with me personally) so if it seems like I’m not responding, I’m probably just at work. The paramedic who submitted this case has requested the follow-up information from his supervisor, but unfortunately she’s out-of-town for […]

37 year old male CC: Unconscious – Discussion

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Here is the follow-up to: 37 year old male CC: Unconscious. This is the 12-lead ECG that was presented. There are a few difficulties involved with this case. First, we have the syncopal episode with possible seizure-like activity and slurred speech. Second, we have an abormal ECG. Third, there is a recent history of chelation […]

37 year old male CC: Unconscious

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EMS is called to evaluate an unconscious 37 year old male. En route to the scene dispatch advises paramedics that the ápatient is now conscious and may have experienced a syncopal episode and seizure-like activity. The spouse believes that the patientámay be having a stroke. On arrival the patient is found lying in bed. He […]

41 year old male CC: Chest pain – Answer

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Thank you for all of the excellent comments on this┬ácase! I was delighted to see such a high level dialog when I checked my blog this morning. Normally I would to answer each of you individually, but since there are 22 comments (so far) I thought I would try a different strategy and post the […]

41 year old male CC: Chest pain

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A 41 year old male is pulled over during morning rush-hour by sheriff’s deputies. He states that he is on his way to the hospital because he is having chest pain. EMS is called to the scene. The patient is awake, alert, and oriented to person, place, time, and event. His skin is pink, warm, […]

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Stuart
Anterior T wave inversions and PE.
Studies (can't remember them off the top of my head) have shown that TWI in V1-4 + III is 85% likely to be RV strain, 15% ischemia. If I see anterior TWI, the very next lead I look to is III
2014-11-23 18:00:51
Arlene R
The Trouble with Sinus Tachycardia
It has been very insightful for me as i read this post. Thanks to the may people who commented. Like many nurses, I was also taught to differentiate svt from st by rate and now I stand corrected. I have a Telemetry test coming up soon, I wont have the patient in front of me…
2014-11-20 19:59:33
Nick
100 yof CC: Rib pain and intermittent spasms
Can't be a potassium imbalance. The TW's wouldn't change and then change back. If it was coronary spasm, I would expect some ST segment elevation. The TW'S are also not hyperacute (peaked). Does she wear some sort of electronic stimulator?
2014-11-19 01:05:43
Anterior T wave inversions and PE. | EMS 12 Lead
Not just S1Q3T3: Look at the other 10 leads!
[…] Last week, I described the case of a middle-aged male with a vague history of heart failure who had been having progressive shortness of breath for 4-5 days. On the day he called 911, he had been walking a short distance when he syncoped. EMS obtained an ECG: […]
2014-11-18 18:33:47
Christine
100 yof CC: Rib pain and intermittent spasms
I believe this may be coronary artery vasospasm.
2014-11-18 11:02:45

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