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Hopefully the attachment works! Sorry that the quality isn't magnificent. I am interested in hearing thoughts on the rhythm since this generated a bit of discussion.

Basic clinical details: 67 year old female complaining of chest pain radiating into her back with associated shortness of breath. Reports a history of a previous MI and angina.

Thoughts?

post-590-0-20317600-1394605849_thumb.jpg

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Keep up the good work Cad, All, Caduceus is making us proud, she came in here an unknown wanting to get training in EMS and look at her. She's really learning. Wouldn't it be great if all our

Hmm...let me read some more on it, Doc, and I'll see what I can come up with.

So, p-waves indicate the electrical stimulation of the atria to pump blood into the ventricles. When they're inverted, it means that the rhythm is junctional or ectopic. I will be back when I figu

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I'm not a medic, but what's with all the flattened P-waves? is that what I am looking at?

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The P waves look inverted. Tells me it's junctional. It's not a great attachment but I could see the inverted waves. Other than that, regular rhythm

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If you look at the Lead II rhythm at the bottom of the attachment, the inverted P waves are there. I agree though. they are hard to see.

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Okay, so P-waves are related with the atria, right? So what does it mean when they're 'inverted'?

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Okay, so the P-wave is when the atria contract, or atrial polarization.

If it's inverted it could mean a premature heart beat, or that the atria aren't contracting.

Is this a precursor of an MI?

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EKGs only tell you about the electrical state of the heart, so it would not tell you anything about contraction or relaxation of the myocardium. Are you sure about that polarization thing?

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Hmm...let me read some more on it, Doc, and I'll see what I can come up with.

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