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INSTRUCTORS' COLLECTION: ACUTE ANTERIOR-LATERAL STEMI

Submitted by Dawn on Sat, 12/23/2023 - 21:15

The Patient:  A 60-year-old man at work. He experienced a sudden onset of
substernal chest pain, nausea & vomiting, and dizziness.  He states the pain is
a 5 on 1-10 scale.  No cardiac history or current medications. 

The ECGs:  The first ECG, taken at 12:30:05, shows a sinus rhythm with
ventricular bigeminy. In some leads, you can see the sinus P waves hidden in the
beginnings of the PVCs, so we know the underlying sinus rhythm is about 82 bpm.

There is obvious ST elevation in V1 through V5, which is the anterior wall, an
area perfused by the left anterior descending artery.  Remember – the ST
elevation sign may also show in the PVCs, but because ventricular beats have
secondary ST changes of their own, we should assess only the sinus beats for ST
changes. 

There is also obvious ST elevation in Leads I and aVL.  This is the high lateral
wall, which is perfused by the circumflex and first diagonal arteries, both
proximal branches of the left coronary artery.  So, the involvement of the high
lateral wall indicates a proximal lesion in the LCA – not good.  Leads III and
aVF have distinct ST depression – this is a reciprocal change reflecting the ST
elevation in Leads I and aVL.

 * 
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EVERYTHING YOU WANTED TO KNOW ABOUT Q WAVES, BY DR. JERRY JONES, MD

Submitted by Dawn on Mon, 02/19/2024 - 18:46
Resource File: 
Everything You Wanted To Know About Q Waves
Category: 
Reference
 * Read more about Everything You Wanted To Know About Q Waves, By Dr. Jerry
   Jones, MD
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AN INTERESTING HOLTER STRIP

Submitted by Dr A Röschl on Wed, 01/17/2024 - 10:24

Here you can see a long rhythm strip from a Holter ECG, written at 25 mm/s. On
the left, a sinus bradyarrhythmia can be seen first, followed by an atrial
tachycardia. After a few beats this changes back into a sinus bradyarrhythmia.
Then follows a short VT over 3 beats, after 1 sinus node beat then a ventricular
couplet. Sinus bradyarrhythmia again at the end.

 * 
 * Read more about An Interesting Holter Strip
 * Dr A Röschl's blog
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ATRIAL FIBRILLATION WITH RATE-RELATED LEFT BUNDLE BRANCH BLOCK

Submitted by Dr A Röschl on Tue, 01/16/2024 - 03:20

For a better overview, the leads aVL and V2-V4 are not shown in this ECG. The
basic rhythm is atrial fibrillation (no P waves or flutter waves visible, but
fibrillation waves). When the conduction rate drops, the QRS complexes are
narrow. Faster conduction results in wide QRS complexes with LBBB morphology.
This is an example of phase 3 (acceleration dependant) LBBB.

 * 
 * Read more about Atrial Fibrillation With Rate-related Left Bundle Branch
   Block
 * Dr A Röschl's blog
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NEW BOOK FROM DR. JERRY JONES

Submitted by Dawn on Mon, 01/01/2024 - 17:26

AVAILABLE NOW at:   AMAZON

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 * Read more about New Book From Dr. Jerry Jones
 * Dawn's blog
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PACEMAKER LEADS: ATRIAL AND BI-VENTRICULAR

Click to open: 


This original artwork was created by Dawn Altman.  It is free for your use in a
non-commercial setting.  For commercial use, contact the artist at
Dawn.ECGGuru@gmail.com. All rights reserved. (c) 2023

 * 
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ECG GLOSSARY FROM DR. KEN GRAUER

Submitted by Dawn on Sat, 06/08/2019 - 14:16

Are you looking for a comprehensive ECG glossary that goes beyond simply
defining words? Dr. Ken Grauer, who is the ECG Guru's Consulting Expert, has a
Glossary available on his website that explains the terms.  Instructors and
students alike will benefit from having this glossary readily available.  The
glossary is exerpted from his e-Publication, "A 1st Book On ECGs - 2014",
available on Amazon.

Tags: 
Dr. Ken Grauer Glossary
 * 
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ECG GURU ADS - PRODUCTS AND SERVICES OF INTEREST TO OUR MEMBERS

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readers, please contact us at Dawn.ECGGuru@gmail.com

 


ECG HISTORY:     ECG WAS FIRST PUT INTO CLINICAL USE IN THE EARLY 1900S.  IN
1909, IT HELPED DIAGNOSE AN ARRHYTHMIA.  A YEAR LATER, INDICATIONS OF A HEART
ATTACK WERE NOTED.

 

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RECENT BLOG POSTS

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 * Atrial Fibrillation With Rate-related Left Bundle Branch Block
 * New Book From Dr. Jerry Jones
 * VENTRICULAR TACHYCARDIA WITH SUCCESSFUL ATP
 * SUSTAINED VENTRICULAR TACHYCARDIA
 * SICK SINUS SYNDROME
 * Atrial Flutter With Right Bundle Branch Block and Left Anterior Fascicular
   Block In a Patient With Preexisting RBBB + LAFB
 * Ventricular Tachycardia. Unsuccessful Antitachycardia Pacing in an ICD
   Patient
 * High-grade AV Block
 * Atrial Flutter Degenerates Into Atrial Fibrillation
 * Sinus Bradycardia and More
 * SMART WATCH ECG
 * Atypical Atrial Flutter (From the Left Atrium)
 * Ventricular Tachycardia
 * Right Bundle Branch Block

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