🔖 #آموزشی
⚠️ #ECG of the week 108
🛑 #ECG case presentation
• Unconscious Patient 68 year old man
• History of a remote MI, was found by his family unconscious on the floor of his apartment. He had been well the morning of presentation.
• Prior to hospital arrival technicians faxed a 12-lead ECG to you (ECG 62A).
🔻After Hospitalization:
• Initial vital signs were notable for a tachycardia and hypotension,
• After appropriate therapy, vital signs stabilized.
• He was intubated prior to arrival.
• Upon admission to the emergency department, a repeat ECG is obtained (ECG 62B).
🔸What is your interpretation of his initial ECG?
🔹What arrhythmia diagnosis is suggested?
🔸What clinical diagnosis is suggested in comparing the two tracings?
✔️Source : Podrid’s Real-World ECGs
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⚠️ #ECG of the week 108
🛑 #ECG case presentation
• Unconscious Patient 68 year old man
• History of a remote MI, was found by his family unconscious on the floor of his apartment. He had been well the morning of presentation.
• Prior to hospital arrival technicians faxed a 12-lead ECG to you (ECG 62A).
🔻After Hospitalization:
• Initial vital signs were notable for a tachycardia and hypotension,
• After appropriate therapy, vital signs stabilized.
• He was intubated prior to arrival.
• Upon admission to the emergency department, a repeat ECG is obtained (ECG 62B).
🔸What is your interpretation of his initial ECG?
🔹What arrhythmia diagnosis is suggested?
🔸What clinical diagnosis is suggested in comparing the two tracings?
✔️Source : Podrid’s Real-World ECGs
🖇مشاهده #تصاویر ECG 👇
📌#پاسخ فردا در همین کانال 👇
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Iranian Society of Atherosclearosis
ECG of the week 108
ECG case presentation
انجمن آترواسکلروز ایران(IRSA)
🔖 #آموزشی ⚠️ #ECG of the week 108 🛑 #ECG case presentation • Unconscious Patient 68 year old man • History of a remote MI, was found by his family unconscious on the floor of his apartment. He had been well the morning of presentation. • Prior to…
⚠️ #ECG of the week 108
👈#پاسخ :
🔸#Answer :
✅ #ECG 62A Analysis: Ventricular tachycardia (sustained monomorphic)
👉#ECG 62A shows a regular rhythm at a rate of 220 bpm. The QRS complex duration is increased (0.18 sec), and the morphology is not typical for either a right or left bundle branch block. Although there are no obvious P waves seen, there are inconsistent abnormalities of the ST-T waves, best seen in leads I (↑) and V1 (↓) .
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👈#پاسخ :
🔸#Answer :
✅ #ECG 62A Analysis: Ventricular tachycardia (sustained monomorphic)
👉#ECG 62A shows a regular rhythm at a rate of 220 bpm. The QRS complex duration is increased (0.18 sec), and the morphology is not typical for either a right or left bundle branch block. Although there are no obvious P waves seen, there are inconsistent abnormalities of the ST-T waves, best seen in leads I (↑) and V1 (↓) .
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انجمن آترواسکلروز ایران(IRSA)
🔸#ECG 62B👆 📲 @IRathero 💫
📎📎📎
🔸#ECG 62B Analysis: Normal sinus rhythm, right atrial hypertrophy (abnormality),
first-degree AV block (prolonged AV conduction), old lateral and anteroapical
myocardial infarction, left ventricular aneurysm, low voltage in limb leads
👉 #ECG 62B shows a regular rhythm at a rate of 78 bpm. There is a P wave before each QRS complex (+) and the PR interval is constant (0.26 sec). The P waves are positive in leads I, II, aVF, and V4–V6.
Hence this is a normal sinus rhythm with a first-degree AV block (prolonged AV nodal conduction). The P waves are tall and peaked in leads II and aVF and all positive in lead V1, consistent with right atrial hypertrophy or a right atrial abnormality. The QRS complex duration is normal (0.08 sec) and there is a normal axis between 0° and +90° (positive QRS complex in leads I and aVF).
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🔸#ECG 62B Analysis: Normal sinus rhythm, right atrial hypertrophy (abnormality),
first-degree AV block (prolonged AV conduction), old lateral and anteroapical
myocardial infarction, left ventricular aneurysm, low voltage in limb leads
👉 #ECG 62B shows a regular rhythm at a rate of 78 bpm. There is a P wave before each QRS complex (+) and the PR interval is constant (0.26 sec). The P waves are positive in leads I, II, aVF, and V4–V6.
Hence this is a normal sinus rhythm with a first-degree AV block (prolonged AV nodal conduction). The P waves are tall and peaked in leads II and aVF and all positive in lead V1, consistent with right atrial hypertrophy or a right atrial abnormality. The QRS complex duration is normal (0.08 sec) and there is a normal axis between 0° and +90° (positive QRS complex in leads I and aVF).
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🔖 #آموزشی
💌 #ECG of the week 109 : Description Quiz
🛑 #Case description:
• 35 year old male Type 1 diabetic.
• Presents feeling generally unwell with abdominal pain and dyspnea.
✳️⁉️Describe and interpret this #ECG
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💌 #ECG of the week 109 : Description Quiz
🛑 #Case description:
• 35 year old male Type 1 diabetic.
• Presents feeling generally unwell with abdominal pain and dyspnea.
✳️⁉️Describe and interpret this #ECG
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Forwarded from اتچ بات
⚠️ #ECG of the week 109
👈#پاسخ :
🔸#Answer :
✅ Rate:
• 48 bpm
Rhythm:
•Irregular
•Nil P waves visible
Axis:
•Right axis deviation
Intervals:
•QRS – Prolonged
Additional:
•ST Elevation leads I, aVL, V1-4
•ST depression leads III, aVF
•Bizarre broad QRS without typical BBB
•Prominent T waves leads V3-6
Key abnormalities:
•Slow atrial fibrillation
•QRS Prolongation
•High lateral ST elevation
•Prominent precordial T waves
The differentials of these ECG findings are relatively broad but the immediate life-threats would be:
•Acute myocardial infarction
•Hyperkalaemia +/- acidaemia
•Drug toxicity
Other causes include myocarditis, cardiomyopathy and hypothermia.
🔻Clinical Outcome
We must always take our ECG differentials to the bedside and consider them within the clinical presentation and scenario. ECG abnormalities in the acutely unwell diabetic should always prompt consideration of hyperkalaemia and acid-base disturbance as the primary cause. We must also be mindful that diabetic emergencies can be precipitated by acute cardiac ischaemia and also cause hypercoagulable states. ...
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👈#پاسخ :
🔸#Answer :
✅ Rate:
• 48 bpm
Rhythm:
•Irregular
•Nil P waves visible
Axis:
•Right axis deviation
Intervals:
•QRS – Prolonged
Additional:
•ST Elevation leads I, aVL, V1-4
•ST depression leads III, aVF
•Bizarre broad QRS without typical BBB
•Prominent T waves leads V3-6
Key abnormalities:
•Slow atrial fibrillation
•QRS Prolongation
•High lateral ST elevation
•Prominent precordial T waves
The differentials of these ECG findings are relatively broad but the immediate life-threats would be:
•Acute myocardial infarction
•Hyperkalaemia +/- acidaemia
•Drug toxicity
Other causes include myocarditis, cardiomyopathy and hypothermia.
🔻Clinical Outcome
We must always take our ECG differentials to the bedside and consider them within the clinical presentation and scenario. ECG abnormalities in the acutely unwell diabetic should always prompt consideration of hyperkalaemia and acid-base disturbance as the primary cause. We must also be mindful that diabetic emergencies can be precipitated by acute cardiac ischaemia and also cause hypercoagulable states. ...
🔹 #Read_more 👇
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📲 @IRathero 💫
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🔖 #آموزشی
💌 #ECG of the week 110 :
🛑 #Case description:
#ECG Case : Wellens syndrome, deep anterolateral T-wave inversion, critical LAD stenosis
•These ECGs were taken from a 40 yr old male who presented with a 60 minute history of central chest pain.
•On arrival to the Emergency Department he was pain free (ECG 1). Four minutes later he developed further intense chest pain and a repeat ECG was performed (ECG 2).
✳️⁉️Describe and interpret this #ECG
🔸این نوار قلب از یک مرد 40 ساله گرفته شده است که برای 60 دقیقه دردهایی در قسمت مرکزی سینه را تجربه کرده است.
• هنگام ورود به اورژانس ، او بدون درد بود (ECG 1). . چهار دقیقه بعد او درد شدید در قفسه سینه حس کرده و تکرار ECG انجام شد (ECG 2).
دو عکس ECG زیر را تفسیر کنید .
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📲 @IRathero 💫
💌 #ECG of the week 110 :
🛑 #Case description:
#ECG Case : Wellens syndrome, deep anterolateral T-wave inversion, critical LAD stenosis
•These ECGs were taken from a 40 yr old male who presented with a 60 minute history of central chest pain.
•On arrival to the Emergency Department he was pain free (ECG 1). Four minutes later he developed further intense chest pain and a repeat ECG was performed (ECG 2).
✳️⁉️Describe and interpret this #ECG
🔸این نوار قلب از یک مرد 40 ساله گرفته شده است که برای 60 دقیقه دردهایی در قسمت مرکزی سینه را تجربه کرده است.
• هنگام ورود به اورژانس ، او بدون درد بود (ECG 1). . چهار دقیقه بعد او درد شدید در قفسه سینه حس کرده و تکرار ECG انجام شد (ECG 2).
دو عکس ECG زیر را تفسیر کنید .
📌#پاسخ فردا در همین کانال 👇
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📲 @IRathero 💫
Iranian Society of Atherosclearosis
ECG of the week 110
ECG Case : Wellens syndrome, deep anterolateral T-wave inversion, critical LAD stenosis
انجمن آترواسکلروز ایران(IRSA)
🔸#ECG 1👆 📲 @IRathero 💫
💌 #ECG of the week 110 :
👈#پاسخ (1-2):
🔸#Answer :
✅Description and interpretation of #ECG 1
-Rate:
•72 bpm
-Rhythm:
• Regular
•Sinus rhythm
-Axis:
•Normal
-Intervals:
•PR – Normal (160ms)
•QRS – Normal (100ms)
• QT – 400ms (QTc Bazett 440 ms)
-Segments:
• ST elevation lead V1 (<1mm)
-Additional:
• Biphasic T wave lead V2
• T wave inversion leads I, aVL, aVR, V1, V3-6
o Deep inversion leads V3-5
• Voltage criteria for LVH
-Interpretation:
The differentials of deep T wave inversion are relatively broad but in a patient with a history of chest pain, a pain free ECG and these ECG features the major concern is Wellens syndrome – signifying a critical LAD lesion.
The subsequent ECG, taken whilst having chest pain, highlights the need to recognize the Wellens pattern.
📲 @IRathero 💫
👈#پاسخ (1-2):
🔸#Answer :
✅Description and interpretation of #ECG 1
-Rate:
•72 bpm
-Rhythm:
• Regular
•Sinus rhythm
-Axis:
•Normal
-Intervals:
•PR – Normal (160ms)
•QRS – Normal (100ms)
• QT – 400ms (QTc Bazett 440 ms)
-Segments:
• ST elevation lead V1 (<1mm)
-Additional:
• Biphasic T wave lead V2
• T wave inversion leads I, aVL, aVR, V1, V3-6
o Deep inversion leads V3-5
• Voltage criteria for LVH
-Interpretation:
The differentials of deep T wave inversion are relatively broad but in a patient with a history of chest pain, a pain free ECG and these ECG features the major concern is Wellens syndrome – signifying a critical LAD lesion.
The subsequent ECG, taken whilst having chest pain, highlights the need to recognize the Wellens pattern.
📲 @IRathero 💫
انجمن آترواسکلروز ایران(IRSA)
🔸#ECG 2👆 📲 @IRathero 💫
💌 #ECG of the week 110 :
👈#پاسخ (2-2):
🔸#Answer :
✅Description and interpretation of #ECG 2
-Rate:
• 84 bpm
-Rhythm:
•Regular
•Sinus rhythm
-Axis:
•Normal
-Intervals:
•PR – Normal (160ms)
•QRS – Normal (100ms)
•QT – 360ms (QTc Bazett 430 ms)
-Segments:
•ST Elevation leads I (<1mm); aVL (1 mm); V1 (1mm); V2 (6mm); V3 (7mm); V4 (7mm); V5 (4mm); V6 (1-2mm)
•ST Depression leads III, aVF
-Additional:
•Note resolution of deep T wave inversion with hyperacute T waves on ST segments in leads V2-3
•Voltage changes as above
-Interpretation:
•Antero-lateral STEMI
• Occlusion of critical lesion suspected from first ECG
📲 @IRathero 💫
👈#پاسخ (2-2):
🔸#Answer :
✅Description and interpretation of #ECG 2
-Rate:
• 84 bpm
-Rhythm:
•Regular
•Sinus rhythm
-Axis:
•Normal
-Intervals:
•PR – Normal (160ms)
•QRS – Normal (100ms)
•QT – 360ms (QTc Bazett 430 ms)
-Segments:
•ST Elevation leads I (<1mm); aVL (1 mm); V1 (1mm); V2 (6mm); V3 (7mm); V4 (7mm); V5 (4mm); V6 (1-2mm)
•ST Depression leads III, aVF
-Additional:
•Note resolution of deep T wave inversion with hyperacute T waves on ST segments in leads V2-3
•Voltage changes as above
-Interpretation:
•Antero-lateral STEMI
• Occlusion of critical lesion suspected from first ECG
📲 @IRathero 💫
💌 #ECG of the week 111 :
🛑 #Interpret the ECG : #ECG Case 111
•71yr old male who
•Presented with several episodes of ischemic sounding
•Chest pain
•Background of known ischemic cardiac disease
-Rate:
•Mean rate 66 bpm
-Rhythm:
•Sinus rhythm
•Unifocal PVCs
-Axis:
•Normal
-Intervals:
•PR – Normal (~200ms)
•QRS – Prolonged (120-130 ms)
•QT – 410ms (QTc Bazett 470 ms)
-Additional:
•QRS fragmentation
oBest seen leads V2-3
oLead V2 rsr’s’r”s” pattern
oLead V3 rsr’s’ pattern
•T wave inversion leads V4-5
•ST elevation leads aVR and aVL (< 1mm)<1mm font=””>
•ST depression leads II, III, aVF
✍️by Dr John Larkin
✳️⁉️Describe and interpret this #ECG
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🛑 #Interpret the ECG : #ECG Case 111
•71yr old male who
•Presented with several episodes of ischemic sounding
•Chest pain
•Background of known ischemic cardiac disease
-Rate:
•Mean rate 66 bpm
-Rhythm:
•Sinus rhythm
•Unifocal PVCs
-Axis:
•Normal
-Intervals:
•PR – Normal (~200ms)
•QRS – Prolonged (120-130 ms)
•QT – 410ms (QTc Bazett 470 ms)
-Additional:
•QRS fragmentation
oBest seen leads V2-3
oLead V2 rsr’s’r”s” pattern
oLead V3 rsr’s’ pattern
•T wave inversion leads V4-5
•ST elevation leads aVR and aVL (< 1mm)<1mm font=””>
•ST depression leads II, III, aVF
✍️by Dr John Larkin
✳️⁉️Describe and interpret this #ECG
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انجمن آترواسکلروز ایران(IRSA)
💌 #ECG of the week 111 : 🛑 #Interpret the ECG : #ECG Case 111 •71yr old male who •Presented with several episodes of ischemic sounding •Chest pain •Background of known ischemic cardiac disease -Rate: •Mean rate 66 bpm -Rhythm: •Sinus rhythm…
💌 #ECG of the week 111 :
🔸#Answer :
✅Description and interpretation of ECG
Interpretation:
•ST and T wave changes
o Likely ACS given history
o Needs serial ECGs and comparison with prior ECGs
• QRS Fragmentation
o Caused by abnormal ventricular repolarisation
o Due to myocardial scarring, fibrosis or ischaemia
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🔸#Answer :
✅Description and interpretation of ECG
Interpretation:
•ST and T wave changes
o Likely ACS given history
o Needs serial ECGs and comparison with prior ECGs
• QRS Fragmentation
o Caused by abnormal ventricular repolarisation
o Due to myocardial scarring, fibrosis or ischaemia
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Iranian Society of Atherosclearosis
ECG of the week 111
Interpret the ECG :
🔖 #آموزشی
⚠️ #سوال کوتاه ، #پاسخ کوتاه
❤️ #ECG QUICK QUIZ 112 ?
🔸19 year old male with complaints of palpitations
What would you do next based on this EKG?
a. Reassure and discharge
b. Refer for electrophysiology study
c. Begin a beta-blocker
👈 #تصویر ECG نشان دهنده ی کدامیک از گزینه های زیر میباشد؟
📄📄در #نظرسنجی شرکت کنید 📄📄
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⚠️ #سوال کوتاه ، #پاسخ کوتاه
❤️ #ECG QUICK QUIZ 112 ?
🔸19 year old male with complaints of palpitations
What would you do next based on this EKG?
a. Reassure and discharge
b. Refer for electrophysiology study
c. Begin a beta-blocker
👈 #تصویر ECG نشان دهنده ی کدامیک از گزینه های زیر میباشد؟
📄📄در #نظرسنجی شرکت کنید 📄📄
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📚📖#آموزشی : 📚📖
🚩#Quiz Of The Week
✅ #EHRA2021 #ECG competition session :
67 yo patient with no history of heart disease presents to the ER with dizziness and palpitations.
What’s the most likely diagnosis?
1. Atrial fibrillation with LBBB
2. Atrial flutter with LBBB
3. Ventricular tachycardia
4. AVNRT with aberration
5. Antidromic AVRT
📄📄در #نظرسنجی شرکت کنید 📄📄
📌#پاسخ فردا در همین کانال 👇
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🚩#Quiz Of The Week
✅ #EHRA2021 #ECG competition session :
67 yo patient with no history of heart disease presents to the ER with dizziness and palpitations.
What’s the most likely diagnosis?
1. Atrial fibrillation with LBBB
2. Atrial flutter with LBBB
3. Ventricular tachycardia
4. AVNRT with aberration
5. Antidromic AVRT
📄📄در #نظرسنجی شرکت کنید 📄📄
📌#پاسخ فردا در همین کانال 👇
🖥 air.ir/ZHmsR
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