tag:blogger.com,1999:blog-549949223388475481.post5766610706322866799..comments2024-03-26T22:42:04.176-05:00Comments on Dr. Smith's ECG Blog: Is this Left Bundle Branch Block? Is there STEMI?Unknownnoreply@blogger.comBlogger9125tag:blogger.com,1999:blog-549949223388475481.post-6096695186510662852014-01-05T11:59:19.094-06:002014-01-05T11:59:19.094-06:00Yes, if still symptomatic.Yes, if still symptomatic.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-72167438867034996522014-01-04T21:16:11.141-06:002014-01-04T21:16:11.141-06:00great clue to STEMI... IF pci not available, would...great clue to STEMI... IF pci not available, would you give thrombolytics ?maateeqhttps://www.blogger.com/profile/10063793989441938455noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-2060932378672683682014-01-03T20:39:34.965-06:002014-01-03T20:39:34.965-06:00Jesse,
You were right. I was wrong. You'll ...Jesse, <br />You were right. I was wrong. You'll see that in answer to MJ above, I corrected the post. They are indeed retrograde P-waves.<br />Thanks,<br />Steve SmithSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-33022724921769948852014-01-03T10:29:45.985-06:002014-01-03T10:29:45.985-06:00Dr. Smith,
It was my understanding that the distan...Dr. Smith,<br />It was my understanding that the distance the impulse had to travel in a retrograde fashion from the ventricle was not sufficient enough to reset the sinus node, which is why PVC's are followed by compensatory pauses. Is this not the case? <br /><br />I just thought that the inverted P waves buried at the end of the QRS's were just retrograde activation from the ventricles, not actually sinus P waves. Was I wrong?Anonymoushttps://www.blogger.com/profile/15501635046301516892noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-13346879574178254252013-12-31T16:11:09.556-06:002013-12-31T16:11:09.556-06:00MJ,
I'm looking again and you are right! I wi...MJ,<br />I'm looking again and you are right! I will fix it.<br />Thanks,<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-59187783441427725882013-12-29T06:15:44.217-06:002013-12-29T06:15:44.217-06:00Emil,
I think you are not finding the J-point accu...Emil,<br />I think you are not finding the J-point accurately. It is a bit later than you might think. Look closely. The true J-point is elevated.<br />Thanks for your comment/question!<br />SteveSteve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-67782410083136313382013-12-29T06:04:52.012-06:002013-12-29T06:04:52.012-06:00This comment has been removed by the author.Steve Smithhttps://www.blogger.com/profile/08027289511840815536noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-46164405247176042212013-12-28T13:54:51.907-06:002013-12-28T13:54:51.907-06:00Hello dr. Smith,
Interesting post! I was wonderin...Hello dr. Smith,<br /><br />Interesting post! I was wondering why you think there is STE elevation in v4 in the prehospital EKG. The j-point does not seem to be elevated compared to the baseline.<br />Kind regards and thanks for your time,<br />Emil<br />Anonymoushttps://www.blogger.com/profile/09389190633543717125noreply@blogger.comtag:blogger.com,1999:blog-549949223388475481.post-58440740375717565672013-12-27T17:44:37.352-06:002013-12-27T17:44:37.352-06:00Interesting case. The p wave is negative and condu...Interesting case. The p wave is negative and conducted retrograde from the ventricle. In the final ECG this can be seen in the lead II rhythm strip. On the left there is no p wave seen initially due to isorhythmic dissociation. On the right the negative p wave is seen in the ST segment. MJ Perrinhttps://www.blogger.com/profile/08177271615863248865noreply@blogger.com