tag:blogger.com,1999:blog-549949223388475481.post3997834133224803905..comments2024-03-26T22:42:04.176-05:00Comments on Dr. Smith's ECG Blog: A young healthy male with epigastric pain and tachycardiaUnknownnoreply@blogger.comBlogger8125tag:blogger.com,1999:blog-549949223388475481.post-42872403892609476842016-05-25T10:26:30.858-05:002016-05-25T10:26:30.858-05:00Emre,
Yes, the ECG could represent proximal LAD, e...Emre,<br />Yes, the ECG could represent proximal LAD, except the echo shows hyperdynamic function, so that hypothesis is thrown out!<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-30307372584460802862016-05-24T11:59:27.452-05:002016-05-24T11:59:27.452-05:00Thanks for this instructive case.
First ECG is a...Thanks for this instructive case. <br /><br />First ECG is also reminiscent of proximal LAD lesion at first glance (V1-V3 ST elevation, inferior and V5-6 depression, aVR ST elevation)(also aVL ST elevation makes it more possible than subedocardial ischemia to me), but of course clinical picture matters. <br /><br />I also suspect there might be a misplacement of the electrodes (V1 and V2 my be higher but why aVL and V5-6 are so different ? Better to be compared with the case on August 12, 2015).<br /><br />Any comment would be highly appreciated.Emre Aslangerhttps://www.blogger.com/profile/15517696935176033792noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-27637795986228398292015-08-30T06:31:33.108-05:002015-08-30T06:31:33.108-05:00Adolfo,
I don't think so. To me, this is clea...Adolfo,<br />I don't think so. To me, this is clearly sinus rhythm.<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-52948361378820869872015-08-29T00:53:05.357-05:002015-08-29T00:53:05.357-05:00Looking at the fifth and last QRS complex in V2 I ...Looking at the fifth and last QRS complex in V2 I notice a clear notch in the following ST segment. Add this finding with the sawtoothed isoelectric line in V4 and V5. This actually make me question sinus rhythm. Can't it rather be atrial tachycardia/atrial flutter with 2:1 conduction rate?Anonymoushttps://www.blogger.com/profile/16480264226835719492noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-82957889412323551962015-08-18T16:18:40.262-05:002015-08-18T16:18:40.262-05:00Olivier,
I believe so!
SteveOlivier,<br />I believe so!<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-53936896385802620402015-08-15T11:28:45.786-05:002015-08-15T11:28:45.786-05:00Great case, Dr Smith.
Could the remarkable ST ele...Great case, Dr Smith.<br /><br />Could the remarkable ST elevations in leads V1, V2, V3 be labelled as LVH strain patterns (Especially when looking at V3) - in this case caused by the aortic regurgitation ?Oliviernoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-71670145667996307382015-08-15T07:13:48.573-05:002015-08-15T07:13:48.573-05:00Yes I just had a patient last night with significa...Yes I just had a patient last night with significant chest pain, no etiology found, but tachycardic. So I did doppler on his aortic and mitral valves because I'm paranoid now!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-6694089222796792332015-08-14T11:16:47.632-05:002015-08-14T11:16:47.632-05:00Just when I start to feel as though I am doing too...Just when I start to feel as though I am doing too many focused echos for "minor" complaints, or minimal VS aberrations, a case like this comes along!<br /><br />This also supports Rob Arntfield's suggestion that a basic color doppler survey of the valves be a routine element of the focused echo.Brooks Walshhttps://www.blogger.com/profile/16108633682893762401noreply@blogger.com