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 patient may 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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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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