ECG: Atrial Infarct
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A 65-year-old man presented with chest discomfort and other symptoms. His ECG showed sinus rhythm with ST elevations and PR interval prolongation. The findings were consistent with an inferoposterior wall myocardial infarction as well as right atrial infarction, likely due to proximal right coronary artery occlusion. Atrial infarction can occur in up to 25% of STEMI cases but is often clinically unrecognized due to its subtle ECG changes such as P-Ta segment elevations. Complications of atrial infarction include arrhythmias and thromboembolism.
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Ecg interpretation
This document provides an overview of systematic ECG interpretation. It discusses the key components that should be analyzed in an ECG including rate, rhythm, axis, P wave, PR interval, QRS complex, QT interval, ST segment, and other waves. For each component, the document outlines what should be assessed such as amplitude, duration, and abnormalities. It also reviews conditions that can cause abnormalities in various ECG components, such as left ventricular hypertrophy, right ventricular hypertrophy, bundle branch blocks, and long QT syndrome. The document emphasizes a systematic approach to ECG interpretation and provides guidance on evaluating rhythms, pediatric considerations, and differentiating ventricular arrhythmias from supraventricular arrhythmias with aberran
ELECTROCARDIOGRAM
1. The document discusses electrocardiographic (ECG) interpretation including determining cardiac rate and rhythm, identifying conduction disturbances, myocardial ischemia or infarction, and other abnormalities.
2. It provides details on properly placing ECG leads and determining the cardiac axis. Common rhythms, conduction blocks, hypertrophy, and other ECG findings are explained.
3. A mnemonic device, RRAHIM, is presented to guide the systematic interpretation of an ECG, covering rate, rhythm, axis, hypertrophy, ischemia/infarction, and other findings.
Cardiovascular System
The document provides an overview of electrocardiography (ECG/EKG) including its uses in diagnosis, components of an ECG reading, normal values, abnormalities, and interpretations. Key aspects of ECG such as P waves, QRS complex, ST segment, T wave, and measurements including axes are defined. Common conditions involving the heart's rhythm and structure that can be identified on ECG are also summarized.
How to read 12 lead ECG
(1) The ECG shows normal sinus rhythm with a heart rate of 75 beats per minute and a slightly prolonged QT interval.
(2) There are abnormal Q waves in leads II, III, and aVF along with ST segment elevations and T wave inversions, consistent with an inferolateral myocardial infarction.
(3) The findings also include an early precordial transition with a relatively tall R wave in lead V2, which could reflect posterior wall involvement.
An Interesting ECG for Discussion
A 50-year-old male presented with chest pain for 3 days. An ECG showed ST elevation in leads 1, aVL, and V7-V9 consistent with a posterior wall myocardial infarction. Additional findings of ST depression and tall T waves in V2-V3 indicated a concurrent high lateral wall MI. Blood tests found elevated troponin levels. Posterior wall MIs involve the dorsal infraatrial portion of the left ventricle and are commonly caused by the left circumflex artery. Complications can include ventricular aneurysm, rupture, mitral valve incompetence, or septal rupture.
Two Interesting ECGs
The document describes two interesting ECG cases.
Case 1 is a 35-year-old male admitted with a chest injury who showed ST elevation and T wave inversion. His troponin levels were elevated.
Case 2 is a 23-year-old male admitted with left-sided weakness who showed ST elevation and T wave inversion as well as QT prolongation. His CK-MB and troponin levels were normal.
The document analyzes the ECG findings and determines that Case 1 represents post-traumatic myopericarditis while Case 2 represents pontine hemorrhage.
Ecg workshop
The document provides an overview of electrocardiography (ECG), describing what a 12-lead ECG is and why it is performed. It explains ECG components like the P wave, QRS complex, and T wave, and how they relate to electrical conduction through the heart. Common arrhythmias, blocks, abnormalities and their ECG presentations are outlined to aid in ECG interpretation.
ecgworkshop-180204063605vvvvvvvvvvvb.pdf
The document provides an overview of basics of ECG reading, including:
- What a 12-lead ECG is and why it is performed to monitor heart rate, rhythm, and detect diseases or disturbances.
- The anatomical position of the heart and impulse conduction pathway.
- Explanation of the P, Q, R, S, and T waves and normal ECG intervals.
- Description of the limb leads and chest leads used to view the heart from different angles.
- How to determine heart rate, rhythm, axis, and identify abnormalities.
Ecg !
1. The document describes 4 ECG findings from patients presenting with various symptoms. The first case shows ventricular bigeminy in a patient with chest pain. The second case shows sinus tachycardia with S1Q3T3 pattern in a bedridden patient with breathlessness, indicating pulmonary embolism. The third case shows ventricular tachycardia in a patient recently diagnosed with myocardial infarction. The fourth case provides the Brugada criteria used to diagnose Brugada syndrome.
Rhythms
The document discusses cardiac rhythms and monitoring. It provides information on:
1) Electrode placements for cardiac monitoring and which leads are best for viewing different waveforms like P waves and QRS complexes.
2) How to interpret a rhythm strip by examining features like heart rate, rhythm regularity, presence of atrial activity, and relationship between atrial and ventricular rhythms.
3) Causes and characteristics of different cardiac rhythms like bradycardias, tachycardias, conduction abnormalities, and rhythms associated with cardiac arrest.
ECG Interpretation
7th PPP upload
This time on ECG
By Dr Md Main Uddin
MBBS, FCPS
Assistant Professor (Medicine)
Cox’s Bazar Medical College
Ecg changes in chamber enlargement
This document discusses ECG changes that occur due to cardiac chamber enlargement, including left atrial, right atrial, biatrial, left ventricular, right ventricular, and biventricular abnormalities. For each type of chamber enlargement, the document outlines the mechanisms, diagnostic ECG criteria, and examples of ECG patterns. Key findings include prolonged P waves and biphasic P waves in leads indicating left and right atrial enlargement, increased QRS voltages and ST-T wave changes indicating left ventricular pressure overload, and tall R waves in right-sided leads indicating right ventricular hypertrophy. The document provides a detailed reference for understanding ECG manifestations of different cardiac structural abnormalities.
ECG BY Dr.MOHAMED RAMADAN
this is a simple work to understand how to read an ECG for medical students
by
M.RAMADAN
E C G M O H A M E D R A M A D A N
This document provides a summary of the basics of electrocardiography (ECG). It discusses the history and development of ECG technology. It describes the normal cardiac conduction system and the waves that make up a normal ECG, including the P, QRS, and T waves. It outlines the 12 standard ECG leads and how they are positioned on the body. It reviews criteria for interpreting common cardiac abnormalities based on ECG findings such as hypertrophy, infarction, and arrhythmias.
ECG: Interpreting ASMI
1. A 35-year-old man presented with retrosternal chest pain radiating to the left arm, associated with diaphoresis and palpitations.
2. An electrocardiogram showed ST segment elevation in leads V1-V4 consistent with an anterior wall myocardial infarction.
3. The ECG findings could help localize the culprit coronary vessel, assess the size of the ischemic area, and prepare for potential complications like heart failure, ventricular arrhythmias, and conduction blocks.
Similar to ECG: Atrial Infarct (20)
Pediatric EGC interpretation... Overview of pediatric ECG
Pediatric EGC interpretation... Overview of pediatric ECG
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A Case of Sheehan's Syndrome
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Imaging: Cortical Vein Thrombosis
A 35-year-old male chronic alcoholic presented with a week-long headache and blurry vision. On examination, he had right lateral rectus palsy. CT brain showed hyperdensity in the right frontal region, right transverse sinus, and hypodensity in the superior sagittal sinus, suggestive of parenchymal hemorrhage with cortical vein thrombosis or calcified granuloma. MRI brain found a hemorrhagic lesion in the right high parietal lobe, absence of flow voids in sinuses, and T1 hyperintensity in sinuses confirming sinus thrombosis, which was shown on MR venography. The patient was diagnosed with cerebral vein thrombosis based on imaging findings.
ECG: Findings in CNS disorders
A 73-year-old male presented with left upper and lower limb weakness. He has a history of diabetes and hypertension. On examination, his pulse was 64 beats/min, blood pressure was 160/100 mmHg, and he had left-sided hemiplegia. An ECG showed normal sinus rhythm, prolonged QT interval of 500ms, and deep anterolateral T wave inversions, which could be due to central nervous system involvement or myocardial ischemia. ECG findings associated with acute central nervous system disorders include prolonged QT interval and deeply inverted T waves in precordial leads.
A Case of Arrhythmogenic Right Ventricular Dysplasia - ARVD
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This document presents the case of a 37-year-old woman admitted with abdominal distension and pain for 3 months. Her history and examination findings revealed hepatomegaly, splenomegaly, fatty liver, and hypothyroidism. Laboratory tests showed anemia and elevated liver enzymes. Imaging confirmed hepatosplenomegaly with fatty liver. She was diagnosed with non-alcoholic steatohepatitis (NASH), pre-obesity, hypothyroidism, and nutritional anemia. Literature discussed in the document suggests an association between hypothyroidism and NASH, as well as hypothyroidism contributing to anemia in some patients. The patient was treated and showed improvement in
IMAGING: NEUROCYSTICERCOSIS
A 16-year-old boy was admitted with abnormal movements of his left thumb and left eyelid for over 1 hour. MRI scans showed lesions in his brain consistent with neurocysticercosis. Neurocysticercosis is caused by the pork tapeworm Taenia solium and has four pathogenic stages seen on imaging. The patient's symptoms, travel history, imaging findings, and positive blood tests confirmed a diagnosis of neurocysticercosis. He was treated with anti-seizure medications, anti-parasitic drugs, and steroids to reduce inflammation from degenerating parasites.
ECG: Digitalis Effect / MAT / AF
A 41-year-old female presented with breathlessness, palpitations, and chest pain for 3 days. She has a history of valvular heart disease surgery 14 years ago. On examination, she was dyspneic, tachycardic, and had pedal edema. ECG showed atrial fibrillation with a rate of 160 beats/minute. Echocardiogram revealed moderate mitral stenosis and mild tricuspid regurgitation with enlarged left atrium and moderate mitral annular calcification. The patient was diagnosed with atrial fibrillation likely due to rheumatic heart disease.
Imaging: BOOP
A 28-year-old male presented with cough, dyspnea, fever, malaise, and weight loss. Chest X-ray and CT scan showed bilateral heterogeneous airspace opacities. He did not improve with antibiotics but responded well to steroids, suggestive of idiopathic bronchiolitis obliterans organizing pneumonia (BOOP). BOOP is a non-specific inflammatory reaction of small airways that can be idiopathic or secondary to various causes. It is treated with steroids and immunosuppressants if unresponsive to steroids.
ECG: Hypokalemia
1. A 52-year-old male presented with loose stools and vomiting for 4 days. Examination found hypokalemia.
2. ECG showed ST segment depression in V3-V6 and prominent U waves, consistent with changes seen in hypokalemia.
3. The patient was diagnosed with hypokalemia likely caused by gastrointestinal potassium losses from diarrhea, as indicated by his symptoms and laboratory findings. Treatment involved potassium supplementation and treatment of the underlying condition causing the diarrhea.
A Case of Idiopathic Pulmonary Hypertension
The document describes a case of a 35-year-old female admitted with complaints of breathlessness, swelling of the legs, and abdominal distension. On examination, she had elevated jugular venous pressure, enlarged liver, edema, and signs of right heart failure. Tests showed pulmonary hypertension, right ventricular dilatation, and cardiomegaly. She was diagnosed with severe pulmonary hypertension of unknown cause.
A Case of Schmidt Syndrome
The document describes a case of a 47-year-old female patient presenting with generalized weakness, giddiness, and other symptoms. After extensive examination and testing, she was diagnosed with Polyglandular Syndrome Type 2 (Schmidt's Syndrome), which involves autoimmune failure of multiple endocrine glands. Key findings included hypothyroidism, adrenal insufficiency, hypogonadism, and anemia. She was started on hormone replacement therapy and other treatment.
A Case of Rodenticide Poisoning
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A Case of Emphysematous Pylonephritis
A 50-year-old lady presented with shortness of breath, fever, cough with sputum production, and swelling of both legs over the past two days. She has a history of type 2 diabetes and hypertension. Examination found decreased breath sounds and mild dehydration. Investigations showed diabetic ketoacidosis, urinary tract infection with E. coli growth, and cirrhosis of the liver. She was diagnosed with type 2 diabetes, hypertension, emphysematous pyelonephritis, and transferred to urology for further management.
Imaging: Multiple Pulmonary Cavitary Lesions
A 38-year-old male smoker presented with swelling all over the body for the past 4 months. Examination revealed pitting pedal edema. Investigations showed elevated ESR, CRP and P-ANCA positivity. CT scan showed multiple cavitary lung lesions. A diagnosis of Wegener's granulomatosis was made based on clinical features, lab investigations and radiological findings.
ECG: Atrial Dissociation
This ECG shows atrial dissociation in a 70-year-old male with a history of hypertension, coronary artery disease, and cardiac transplantation 6 months prior. Atrial dissociation is seen as two independent sets of P waves with varying PP and PR intervals. Atrial dissociation occurs when each atrium beats separately due to blockage of the Bachmann's bundle interatrial pathway. It can occur in orthotopic and heterotopic heart transplant patients as the posterior atrial wall is retained but denervated after orthotopic transplant.
A Case of Hepato-Pulmonary Syndrome
This case involves a 35-year-old female with a history of non-cirrhotic portal fibrosis, splenectomy, recurrent tuberculosis, and recurrent bouts of hematemesis and fever. She presents with cyanosis, clubbing, and shortness of breath. Testing reveals findings consistent with hepatopulmonary syndrome, including low oxygen saturation that decreases further in an upright position. A contrast echocardiogram confirms intrapulmonary vascular dilations. She is diagnosed with severe, longstanding hepatopulmonary syndrome secondary to non-cirrhotic portal hypertension.
A Case of Thalassemia
A 25-year-old male presented with a history of anemia since childhood. Examination found pallor and hepatosplenomegaly. Investigations revealed microcytic hypochromic anemia and bone marrow aspiration showed erythroid hyperplasia consistent with thalassemia intermedia. Patients with thalassemia intermedia have variable clinical presentations between thalassemia major and minor, and may require lifelong monitoring and chelation therapy to manage iron overload from ineffective erythropoiesis.
A Case of Renal Amyloidosis
The document summarizes the case of a 60-year-old male admitted with generalized swelling of the body for 20 days. Investigations revealed IgA monoclonal gammopathy and renal biopsy showed features of amyloidosis. The patient was diagnosed with primary amyloidosis (AL type) associated with hepatitis B infection. Treatment with diuretics and antibiotics improved his symptoms and kidney function recovered.
CXR: Silico-Tuberculosis
A 52-year-old female patient presented with complaints of breathlessness and dry cough for the past 6 months. She has a history of treated pulmonary tuberculosis 3 years ago and treated Pott's spine 2 years ago. Examination revealed wheezing and generalized pigmentation. Chest X-ray showed bilateral lung parenchymal lesions and hilar lymph node calcifications. The final diagnosis was occupational lung disease of silicosis complicated by silicotuberculosis due to exposure to silica particles in her work in sand filtration for brick production.
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