Tag Archives: r wave progression

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 […]

Precordial Leads – The Transition, R-Wave Progression, R/S Ratio in Lead V1

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Since we covered the first 6 leads of the 12 lead ECG in the 6-part tutorial on axis determination, a few words about the precordial leads might be in order. These are leads V1-V6, the unipolar leads that are placed directly on the patient’s chest. The heart is a 3 dimensional object, and calculating the […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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Comments
Brian
83 Year Old Male: Shortness of Breath
I mostly agree with dustin. I believe this is may be an isolated posterior MI. The R wave in V2 points to it being a posterior MI. otherwise it is a 1st degree av block with a LAHB. I am somewhat concerned with the concordant t segment depression noted and in fact if you were…
2014-10-30 04:22:44
Karl Brennan
Understanding Amiodarone
Great article , however in VF caused by hyperkalemia it should be avoided along with lidocaine , Since it shuts down the K channels, the eiteiology of the arrest hyper K, K channels are needed to exchange K in the cell. Calcium , Bicarbonate, dextrose and insulin should be used to decrease K levels along…
2014-10-30 03:04:45
Dustin
83 Year Old Male: Shortness of Breath
I see a very sick and complicated patient. 12 Lead: ST elevation in AVR and V1 along with depression in I, II, V4-V6 leading me to an LMCA occlusion. The tall R wave in V2 also points me to Posterior involvement. Posterior MIs and LMCA occlusions can and do cause pulmonary edema, which this patient…
2014-10-30 02:38:21
Adrian
83 Year Old Male: Shortness of Breath
Firstly, the patient is septic, he needs high flow O2 (which he's already receiving), IV fluids, blood cultures and antibiotics (most likely IV) and needs to be in resus sharpish. Secondly, the ECG needs doing again, V2 is wrong and I'm not sure where it's been placed to get that reading. Assuming the rest of…
2014-10-30 01:00:42
Ken Grauer, MD
83 Year Old Male: Shortness of Breath
I see a regular rhythm at ~ 95/minute with LOTS of baseline artifact. I am not certain if there are P waves or not ..... It does look in leads V3,V4 like there are P waves with a long PR interval - but I cannot be certain in lead II that there is an upright…
2014-10-30 00:59:40

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