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 […]

EMS 12-Lead

Cardiac Rhythm Analysis, 12-Lead ECG Interpretation, Resuscitation
Comments
Justin
Rate Related VS. Primary ST-T Changes:
I'm not sold on true A-Fib, as there is a fusion beat/PAC visible in lead V1, additionally I think that the "U" waves are possibly atrial activity. This pt could be having a fib/ flutter pattern; but its hard to say without slowing down the rate and getting expert consultation from a cardiologist. I Would…
2014-09-22 23:20:29
Billy Bob
Rate Related VS. Primary ST-T Changes:
I think I will have to agree with Michael; I just don't see all that much evidence of WPW; typically with WPW & AF the complexes vary in width and morphology due to the combination of the accessory pathway and normal pathways which I just don't see here. The rate doesn't seem to match what…
2014-09-22 19:02:24
Christopher
59 year old male: chest pressure – Conclusion
I read back over the details on this case and they didn't include whether or not the patient was Left-dominant. Your hunch is probably correct!
2014-09-22 12:55:42
Jonathan
Magnesium and Cardiac Action Potential
I have a background in biochemistry, and so am able to navigate the medical science more than someone without this background. My mom has atrial fibrillation, and so I decided to do some investigation. I am AMAZED to find out how little her primary care doctor knows about Magnesium/Potassium/Calcium concentrations as they pertain to Atrial…
2014-09-22 03:46:58
Jeff
Rate Related VS. Primary ST-T Changes:
He's complaining of 10/10 chest pain that coincided with palpitations with a HR of 206 that is probably A-Fib. I am guessing that if you correct his rate you will allow his myocardium to become perfused again and his chest pain will subside. I would pre-sedate him with Midazolam 2mg and electrically cardiovert starting @…
2014-09-21 19:17:36

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