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 patient is now conscious and may have experienced a syncopal episode and seizure-like activity. The spouse believes that the patientmay 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 case! 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 […]

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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Comments
Ken Grauer, MD
The 360 Degree Heart – Part II
Nice case Vince (!) - as you lay the ground for your "pet concept" of the vector approach to ST elevation. That said, for those vectorially-challenged readers (like myself) - I offer the following 2 concepts: i) This is not diffuse subendocardial ischemia because the ST depression is not "diffuse". Instead - there is no…
2014-10-26 05:13:56
Stephen Smith
Conclusion: “And then I gave her a NTG…”
There is also no data I'm aware of that shows that, in the reperfusion era, nitroglycerine helps patients with STEMI who do not have elevated BP or pulmonary edema. Data is lacking in all regards.
2014-10-24 16:14:36
Kevin
44 year old male CC: Palpitations
Why on earth would you risk VF, by giving Adenosine to rule out rhythms.. This is dangerous, and foolish. There might be a slight chance that this is WPW.. You might as well just give him Cardizem, they are both AV nodal blockers... I don't know why the AHA even added this stupid idea..
2014-10-22 13:31:06
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

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