Tag Archives: strain pattern

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. […]

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 […]

Left ventricular hypertrophy – Part II

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I know I promised to go over the voltage criteria for left ventricular hypertrophy (LVH) but I lied! If you’re really interested you can check out the Wikipedia article HERE, the ECG Learning Center HERE, or Tom Evans’ crib sheet HERE. Personally? I think it’s a distraction. As far as STEMI recognition goes, it misses […]

Left ventricular hypertrophy – Part I

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One of the most confusing ST-elevation mimics for paramedics is the “strain pattern” (or repolarization abnormality) occasionally found with left ventricular hypertrophy. This is important because left ventricular hypertrophy is one of the most common causes of ST segment elevation in chest pain patients. Many 12 lead ECG classes teach paramedics to recognize the voltage […]

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Comments
Stephen Smith
59 Year Old Male: Unwell
Not VT. This is atrial fib with RVR and anterolateral STEMI in the presence of RBBB/LAFB. Possible superimposed hyperK. Needs cardioversion, then repeat ECG. STEMI can sometimes be due to demand ischemia and one must repeat the ECG after rapid rate is slowed.
2015-06-30 12:45:31
Casey
59 Year Old Male: Unwell
Afib with RBBB and LAHB. Extensive Antero-lateral STEMI with reciprocal changes seen in inferior leads. The rate is obviously a concern but this has been developing for 8 hours (possibly with an acute decline starting 30 mins ago), so I feel comfortable getting an IV and fluid started before shocking his angry heart. My initial…
2015-06-30 01:24:19
Rick G
59 Year Old Male: Unwell
Afib RVR, with RBBB with AnterioLateral wall MI
2015-06-30 00:46:44
Kevin
59 Year Old Male: Unwell
I would cardiovert this pt ASAP, rales, hypotension, and chest heaviness.. I would also call this an antero- high lateral MI.. Anterior decending, and circumflex..definitely not VT, it's irregular..
2015-06-29 23:05:08
Spencer
59 Year Old Male: Unwell
Note my comment about raising his pressure up before using it.
2015-06-29 22:21:26

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