Your SlideShare is downloading. ×
ECG: Bifascicular Block
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply
0 Comments
3 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
6,435
On Slideshare
0
From Embeds
0
Number of Embeds
3
Actions
Shares
0
Downloads
90
Comments
0
Likes
3
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. ECG OF THE WEEK
    PROF.S.SUNDAR UNIT
  • 2.
  • 3. ECG FINDING
    RATE 150/MIN
    RHYTHM AF/IRREGULARLY IRREGULAR
    AXIS -80⁰/LEFT AXIS DEVIATION
    P WAVE ABSENT
    QRS COMPLEX Q WAVE V1-V4
    SECONDARY R WAVE WITH SLURRING,WIDENING V1-V4
    WIDENED TERMINAL S WAVE V5,6 S/O AWMI WITH RBBB
    rS pattern in II,III and aVF s/o LAFB
    A SINGLE VENTRICULAR ECTOPIC IS SEEN
    ST SEGMENT Elevation v1-v4 s/o ACUTE AWMI
    T WAVE SYMMETRICAL, DEEP INVERSION V1 -V4 S/O PRIMARY CHANGES
  • 4.
  • 5. DIAGNOSIS
    ACUTE ANTERIOR WALL MYOCARDIAL INFARCTION WITH BI-FASCICULAR BLOCK(RBBB WITH LAFB)
    ATRIAL FIBRILLATION
  • 6. MI WITH BLOCK
    LBBB MAY BE MISINTERPRETED AS RECENT ANTROSEPTAL MI
    MI MAY BE MASKED BY PRESENCE OF LBBB
    RBBB NEITHER MIMICS NOT MASKS MOST MI
  • 7. MI WITH RBBB
    RBBB AFFECTS MID AND TERMINAL PORTIONAL OF QRS COMPLEX
    SINGLE EXCEPTION- POSTERIOR BASAL MI WHICH AFFECT TERMINALPART QRS AND MASKED BY RBBB
  • 8. RBBB WITH ANTERIORWALL MI
    R WAVE DISAPPEAR IN V1-V4 AND REPLACED BY QWAVE DUE TO INVOLMENT OF ANTERIORWALL OF RV
    SECONDARY R WAVE PERSIST DUE TO DELAYED ACTIVATION OF UNINVOLVED FREEWALL OF RV
  • 9. RBBB WITH INFERIORWALL MI
    MINIMAL INFLUENCE ON THE ANTERIORWALL LEADS
    QWAVE AND ST SEGMENT CHANGES IN INFERIORWALL LEADS ALONG WITH RBBB PATTERN IN PRECARDIAL LEADS
  • 10. PROGNOSIS
    MI WITH LAFB – MINIMAL ADVERSE EFFECT ON PROGNOSIS
    MI WITH LAFB WITH RBBB – POOR PROGNOSIS MORTALITY 4-5TIMES INCREASED
    MI WITH LPFB WITH RBBB – POOR PROGNOSIS MORTALITY 6-7 TIMES INCREASED
    10 MI WILL DEVELOP BIFSCICULAR BLOCK
  • 11.
  • 12. THANK YOU

×