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FL_Medic

Strip Tease 3

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We only briefly touched on 12 lead, so I'm using lead 2 here. From what I can tell it's a sinus rhythm with st segment elevation indicating an ami. I'm not sure where the mi is though. Or why the qrs deflection is negative.

Thank you for posting this, btw. I love learning more indepth than what we are doing in class.

Edited by Jeepluv77

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I feel this may turn out to be less in depth than you are presuming. You're welcome though.

Ps. Check out the first two strip teases.

Edited by FL_Medic

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We only briefly touched on 12 lead, so I'm using lead 2 here. From what I can tell it's a sinus rhythm with st segment elevation indicating an ami. I'm not sure where the mi is though. Or why the qrs deflection is negative.

Thank you for posting this, btw. I love learning more indepth than what we are doing in class.

Sinus rhythm with 1st degree AVB, RBBB (assuming QRS > 0.12s), and left axis deviation. Possible ST elevation in the inferior leads, though would need to see a larger scan so I could go "box counting".

Edited by scott33

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We only briefly touched on 12 lead, so I'm using lead 2 here. From what I can tell it's a sinus rhythm with st segment elevation indicating an ami.

The ST elevation in the lead II tracing would not be indicative of an MI, (no matter how high it was) as it there has to be elevation in contiguous leads (or groups). You may also notice that the gain was turned up on the single lead strip for clarity, which tends to exaggerate elevations and depressions.

What this strip was indicative of, was running a 12-lead for a closer look. As you can see, the results are more subtle, but can yield a lot more "other stuff", which should be taken into consideration along with the patient's chief complaint and other findings of the physical exam.

The only problem I have with "inf MI" is the lack of reciprocal changes, so I still wouldn't put money on it.

Maybe if we get the patient's S/S we may have a better idea.

Edited by scott33

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I see an Inferoir MI, and possibe J. or V. Tach.

"In lead two you got no clue" Bob Page

Obvious P waves.

I am unsure of the Hx. These strips are sent to me in the same format. The only advantage I have is the ability to zoom in, and see them better. Sorry. Wish I knew the full presentation as well.

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Changes in leads 2,3 and avf suggesting inferior infarct, RBBB, slight axial deviation,

oh yes and squinting hard enough 1st degree AV block, some beautiful Q waves there too, not so sure on J tach though,

This is good one FL :)

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maybe my eyes are tired from the shift but that appears to be a paced rhythm thus nothing can be said about ST elevations

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maybe my eyes are tired from the shift but that appears to be a paced rhythm thus nothing can be said about ST elevations

There is p waves, no pacing spike, p wave = sinus if qrs follows in normal sync

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