Tag Archives: right bundle branch block

59 year old male: chest pressure – Conclusion

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This is the conclusion to 59 year old male: chest pressure, be sure to read the case study first! When we left off, we’d loaded our 59 year old male patient with 10 of 10 chest pressure into the back of our unit with the help of a local volunteer EMT. The patient appeared acutely unwell […]

RBBB Abnormalities Missed

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The original presentation of this case appeared as  "What's Wrong with Mr. Wilson?"… You can read the original post here. Much has been written lately about RBBB abnormalities that were missed.  Dr. Smith has recently posted two cases here, and here discussing this. First, let's review the 12 lead of a typical RBBB. When learning […]

77 year old female: Unresponsive – Discussion

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This is the discussion for 77 year old female: Unresponsive, if you have not read the case report we recommend you start there! First, a hat tip to our readers who were unafraid to tackle this challenging scenario. Second, we were very impressed to see a number of readers correctly identify this challenging rhythm! When we […]

63 Year Old Male: "Dental Pain" — Discussion

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This is the discussion to "63 year old male: "Dental Pain". You may wish to review the case. For starters, i think we all agree that the patient, with his signs and symptoms, needs to be transported. We have all had patients like this who don't want to go, even though we know they should. […]

81 year old female CC: Chest Pain – Conclusion

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This is the conclusion to 81 year old female CC: Chest Pain. Due to a significant language barrier, we were unable to obtain a useful medical history. Yet this case highlights the importance of a good scene assessment to gain additional information of clinical importance. First, let's examine the patient's 12-Lead ECG. We have a bradycardic, […]

68 year old male CC: Chest Pain – Conclusion

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This is the conclusion to 68 year old male CC: Chest Pain. When we last left off, our patient was sitting outside a convenience store with a sensation of, "somebody punching me in the chest". Our patient had a fast, irregular pulse, and we had acquired a rhythm strip and a 12-Lead ECG. The rhythm strip shows […]

64 year old male CC: Indigestion – Discussion

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This is the discussion to 64 year old male CC: Indigestion. If you recall, we had a stubborn gentleman complaining of indigestion with a significant cardiac history. Considering the symptoms kept our patient awake, are highly suggestive of a coronary event, and we have uncompensated hypotension, we should have a keen interest on any ECG […]

78 year old male CC: Dizziness – Conclusion

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There were so many great comments on this case, including some great discussion on classifying wide complex tachycardias!

An unusual case of right bundle branch block – Discussion

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Here is the conclusion to an unusual case of right bundle branch block. Let's take another look at the 12-lead ECG. This 12-lead ECG shows acute anterior STEMI in the presence of right bundle branch block, but you really need a trained eye to see it. We talk a lot about the "rule of appropriate […]

An unusual case of right bundle branch block

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We Yankees can learn a lot from the way they do things across the pond.

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EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation

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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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