tag:blogger.com,1999:blog-549949223388475481.post4700324597650234770..comments2024-03-28T14:02:08.119-05:00Comments on Dr. Smith's ECG Blog: Giant R-waves. What are they?Unknownnoreply@blogger.comBlogger10125tag:blogger.com,1999:blog-549949223388475481.post-15213294375817368242015-08-28T08:45:29.711-05:002015-08-28T08:45:29.711-05:00Mostafa,
I see what you mean. It looks like LBBB ...Mostafa,<br />I see what you mean. It looks like LBBB because it is AIVR. There is some minimal concordant ST depression in V2 and V3, which if it were LBBB would be suspicious for posterior MI. Does Sgarbossa apply to AIVR? Probably. In this case, we know the LAD and anterior wall are the culprit and so, if this does signify ischemia, it is probably residual subendocardial ischemia of the anterior wall.<br />OK?<br />STeveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-77390840521983627102015-08-27T10:38:47.997-05:002015-08-27T10:38:47.997-05:00I mean fourth ECG in this case , Which shows AIVR ...I mean fourth ECG in this case , Which shows AIVR with Heart rate 75 , does its look like LBBB with ST depression in V2,V3 ?Anonymoushttps://www.blogger.com/profile/06475696764299734880noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-55062453688773532002015-08-27T08:19:33.405-05:002015-08-27T08:19:33.405-05:00Sgarbossa applies to left bundle branch block, not...Sgarbossa applies to left bundle branch block, not right bundle branch block.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-21290891641742375962015-08-27T08:19:04.376-05:002015-08-27T08:19:04.376-05:00Thanks, Ken!Thanks, Ken!Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-64916288916653406142015-08-27T06:59:08.455-05:002015-08-27T06:59:08.455-05:00Why not to consider ST-segment depression V2, V3 ,...Why not to consider ST-segment depression V2, V3 ,Sgarbossa B criteria in the AIVR ?Anonymoushttps://www.blogger.com/profile/06475696764299734880noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-5361217869005986212015-08-27T06:10:03.398-05:002015-08-27T06:10:03.398-05:00GREAT case Steve/Brooks! Agree that the rhythm in ...GREAT case Steve/Brooks! Agree that the rhythm in the initial tracing is likely to be posterior fascicle escape. QRS morphology shows RBBB/LAHB and not nearly as wide as was initially thought — with to me lead V6 being a KEY CLUE that ST elevation is the real problem — with those deceptive but truly giant R waves in other chest leads. THANKS for presenting!ECG Interpretationhttps://www.blogger.com/profile/02309020028961384995noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-60729509100097480662015-07-04T13:12:59.676-05:002015-07-04T13:12:59.676-05:00Olivier, I do not think so. In fact there may alr...Olivier, I do not think so. In fact there may already be AIVR of a different morphology on the first ECG.<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-33456809708583947792015-07-04T13:11:36.329-05:002015-07-04T13:11:36.329-05:00It could be. Alternatively, there might be AIVR h...It could be. Alternatively, there might be AIVR here too. With a left posterior fascicular escape.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-27058285316938440732015-07-04T06:22:19.361-05:002015-07-04T06:22:19.361-05:00Hi Dr Smith,
Good case again.
Is a run of non-su...Hi Dr Smith,<br /><br />Good case again.<br /><br />Is a run of non-sustained VT the common pattern phenomenon preceding/leading to an AIVR (Similar to a downshifting maneuver in car manual transmission to make an automobile comparison) or is it directly correlated to the dynamic changes occuring in the opening of the artery ? I mean, would the VT go the sustained route if the artery wasn't open enough ?<br /><br />Olivier. Oliviernoreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-38888287018681513552015-07-03T13:57:29.274-05:002015-07-03T13:57:29.274-05:00Spectacular case. What about the rhythm on the fir...Spectacular case. What about the rhythm on the first ECG? I'm not sure I see P waves. Maybe right after the T wave in aVL with a very long PR?Anonymoushttps://www.blogger.com/profile/10807079731556500879noreply@blogger.com