Stepwise interpretation of ECG ID122
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A 50-year-old man presented with palpitations. An ECG identified atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute. The ECG showed typical flutter waves and normal QRS complexes without signs of bundle branch block, ventricular hypertrophy, or myocardial infarction. The T waves were normal except in inferior leads and V6 where the saw-tooth pattern of atrial flutter made assessment difficult. The final diagnosis was atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute.
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Stepwise interpretation of ECG ID122
A 50-year-old man presented with palpitations. An ECG showed atrial flutter with a variable atrioventricular block and a ventricular rate of 107 beats per minute. The QRS complexes were normal with no signs of bundle branch block or myocardial infarction. The final diagnosis was atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute.
Stepwise interprearion ECG #10
A 50-year-old man presented with palpitations. An ECG showed atrial flutter with a ventricular rate of 107 beats per minute and variable atrioventricular block. The QRS complex was normal in axis and duration with no signs of bundle branch block, ventricular hypertrophy, or prior myocardial infarction. The T waves were normal except in inferior leads and V6 where the saw-tooth pattern of atrial flutter made assessment difficult. The final diagnosis was atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute.
Stepwise interpretation of ECG - #12 no Dx ID 111
A 56-year-old man presented with an episode of syncope. An ECG was performed which showed sinus rhythm with complete heart block, where the atrial rate was 80/min and the ventricular rate was 43/min. The dissociation of the P waves and QRS complexes along with the narrow QRS escape rhythm indicated the ventricular activation was coming from the AV junctional area. The ECG was otherwise normal.
Ecg quiz2
1) The ECG shows sinus node exit block, which involves failure of the sinus node to depolarize or failure of impulse conduction from the sinus node to the atria.
2) This can be seen during anesthesia, drug therapy, myocardial ischemia/infarction, or fibrosis of the sinus node.
3) The patient has a regular rhythm but the length of the pause is not a multiple of the sinus interval, which can occur in healthy individuals or those with increased vagal tone, myocarditis, MI, or digitalis toxicity. Treatment depends on the underlying cause.
Conduction abnormalities
The document discusses the conduction system of the heart and bundle branch blocks. It notes that a bundle branch block is diagnosed when the QRS duration is over 120ms, there is a dominant S wave in V1, and a broad monophasic R wave in lateral leads. It lists causes of left bundle branch block such as aortic stenosis, dilated cardiomyopathy, and myocardial infarction. It explains how left bundle branch block leads to reversed septal activation and prolonged conduction time to the left ventricle. The document also discusses right bundle branch block and potential causes like pulmonary embolism, ischemic heart disease, and cardiomyopathy.
ECG: Atrial Rhythm
A 60-year-old woman with hypertension presented with chest pain. Her initial ECG showed sinus rhythm with ST segment changes. A repeat ECG showed an atrial rhythm with P waves inverted in some leads and upright in others. This finding suggested an ectopic left atrial rhythm. A subsequent ECG reverted back to sinus rhythm similar to the initial test. The document discusses using P wave morphology, particularly in leads V1 and aVL, to differentiate between right and left atrial rhythms. A positive P wave in V1 indicates a left atrial focus while an upright or biphasic P wave in aVL suggests a right atrial origin.
Atrial flutter and bradycardias
This document discusses atrial flutter with 2:1 atrioventricular block. Key points include:
- There is a narrow complex tachycardia at 150 bpm with no visible P waves. Flutter waves are seen at 300 bpm in one lead.
- This is indicative of atrial flutter with a 2:1 block, resulting in a heart rate of 150 bpm.
- Flutter waves can be difficult to see with 2:1 block. Regular rates of 150 bpm suggest this rhythm, especially if extremely consistent.
ECG: A Case of Flutter-Fibrillation
A 70-year-old woman presented with chest pain and palpitations. Her ECG showed atrial flutter with an atrial rate of 340 beats per minute and ventricular rate of 60 beats per minute. The morphology of the flutter waves indicated clockwise conduction around the left atrial circuit, consistent with type I atrial flutter. Treatment options for atrial flutter aim to control the ventricular rate, restore normal sinus rhythm, prevent recurrence, and minimize thromboembolic risk. Catheter ablation can eliminate the reentrant circuit causing atrial flutter.
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Stepwise interpretation of ECG ID122
A 50-year-old man presented with palpitations. An ECG showed atrial flutter with a variable atrioventricular block and a ventricular rate of 107 beats per minute. The QRS complexes were normal with no signs of bundle branch block or myocardial infarction. The final diagnosis was atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute.
Stepwise interprearion ECG #10
A 50-year-old man presented with palpitations. An ECG showed atrial flutter with a ventricular rate of 107 beats per minute and variable atrioventricular block. The QRS complex was normal in axis and duration with no signs of bundle branch block, ventricular hypertrophy, or prior myocardial infarction. The T waves were normal except in inferior leads and V6 where the saw-tooth pattern of atrial flutter made assessment difficult. The final diagnosis was atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute.
Stepwise interpretation of ECG - #12 no Dx ID 111
A 56-year-old man presented with an episode of syncope. An ECG was performed which showed sinus rhythm with complete heart block, where the atrial rate was 80/min and the ventricular rate was 43/min. The dissociation of the P waves and QRS complexes along with the narrow QRS escape rhythm indicated the ventricular activation was coming from the AV junctional area. The ECG was otherwise normal.
Ecg quiz2
1) The ECG shows sinus node exit block, which involves failure of the sinus node to depolarize or failure of impulse conduction from the sinus node to the atria.
2) This can be seen during anesthesia, drug therapy, myocardial ischemia/infarction, or fibrosis of the sinus node.
3) The patient has a regular rhythm but the length of the pause is not a multiple of the sinus interval, which can occur in healthy individuals or those with increased vagal tone, myocarditis, MI, or digitalis toxicity. Treatment depends on the underlying cause.
Conduction abnormalities
The document discusses the conduction system of the heart and bundle branch blocks. It notes that a bundle branch block is diagnosed when the QRS duration is over 120ms, there is a dominant S wave in V1, and a broad monophasic R wave in lateral leads. It lists causes of left bundle branch block such as aortic stenosis, dilated cardiomyopathy, and myocardial infarction. It explains how left bundle branch block leads to reversed septal activation and prolonged conduction time to the left ventricle. The document also discusses right bundle branch block and potential causes like pulmonary embolism, ischemic heart disease, and cardiomyopathy.
ECG: Atrial Rhythm
A 60-year-old woman with hypertension presented with chest pain. Her initial ECG showed sinus rhythm with ST segment changes. A repeat ECG showed an atrial rhythm with P waves inverted in some leads and upright in others. This finding suggested an ectopic left atrial rhythm. A subsequent ECG reverted back to sinus rhythm similar to the initial test. The document discusses using P wave morphology, particularly in leads V1 and aVL, to differentiate between right and left atrial rhythms. A positive P wave in V1 indicates a left atrial focus while an upright or biphasic P wave in aVL suggests a right atrial origin.
Atrial flutter and bradycardias
This document discusses atrial flutter with 2:1 atrioventricular block. Key points include:
- There is a narrow complex tachycardia at 150 bpm with no visible P waves. Flutter waves are seen at 300 bpm in one lead.
- This is indicative of atrial flutter with a 2:1 block, resulting in a heart rate of 150 bpm.
- Flutter waves can be difficult to see with 2:1 block. Regular rates of 150 bpm suggest this rhythm, especially if extremely consistent.
ECG: A Case of Flutter-Fibrillation
A 70-year-old woman presented with chest pain and palpitations. Her ECG showed atrial flutter with an atrial rate of 340 beats per minute and ventricular rate of 60 beats per minute. The morphology of the flutter waves indicated clockwise conduction around the left atrial circuit, consistent with type I atrial flutter. Treatment options for atrial flutter aim to control the ventricular rate, restore normal sinus rhythm, prevent recurrence, and minimize thromboembolic risk. Catheter ablation can eliminate the reentrant circuit causing atrial flutter.
wide complex tachycardia
This document summarizes an ECG of a 55-year-old male patient presenting with palpitations. The initial ECG shows a wide complex tachycardia. Differential diagnoses include ventricular tachycardia or supraventricular tachycardia with aberrancy. ECG features favoring ventricular tachycardia over supraventricular tachycardia are discussed, including Brugada criteria and the lead AVR algorithm. Analysis of the patient's ECG determines the rhythm is ventricular tachycardia with left bundle branch block morphology based on his history of myocardial infarction.
ECG: Atrial Infarct
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.
ECG: Quiz
This document contains ECG readings and descriptions of various cardiac conditions including: multifocal atrial tachycardia, atrial flutter with 2:1 AV block, paroxysms of atrial tachycardia, ventricular tachycardia with AV dissociation, inferior wall myocardial infarction, sinus rhythm with atrial ectopics and complete heart block, acute inferior myocardial infarction, polymorphic ventricular tachycardia, and wide complex tachycardia suggestive of left anterior descending artery involvement. The document aims to teach identification of cardiac conditions based on ECG features.
ECG #12 - ID 111 - CHB
This document discusses the stepwise interpretation of an ECG for a patient. It identifies that the patient, a 56-year-old man who had an episode of syncope, has sinus rhythm with complete heart block. The atrial rate is 80/min while the ventricular rate is 43/min, showing dissociation between the two rhythms. The QRS complexes originate from the AV junction at a rate of 43/min, indicating an escape junctional rhythm. The final diagnosis is sinus rhythm with complete heart block and an escape junctional rhythm supplying the ventricles.
Stepwise interpretation of ECG - #12 no Dx ID111
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape pacemaker was in the AV junction, resulting in an escape junctional rhythm controlling the ventricles. The ECG was otherwise normal.
Wide Complex Tachycardia
This document discusses the differential diagnosis and evaluation of wide complex tachycardia. It lists the main differential diagnoses as ventricular tachycardia, supraventricular tachycardia with pre-existing conduction abnormalities, supraventricular tachycardia with aberrant conduction, electrolyte abnormalities, or conduction over an accessory pathway. When in doubt, it is safest to assume it is ventricular tachycardia, especially in patients with cardiovascular disease. The document outlines criteria to consider in the history and examination and ECG features that can help differentiate ventricular tachycardia from supraventricular tachycardia.
Wide complex tachycardia
This document discusses wide complex tachycardias and how to differentiate them based on electrocardiogram (ECG) findings. It provides details on what makes a complex narrow or wide, types of wide complex tachycardias including ventricular tachycardia and supraventricular tachycardia, and ECG criteria to help determine the source and mechanism such as the presence or absence of RS complexes and their intervals. Morphologic criteria on the ECG and algorithms like the ACC algorithm are presented to aid in differential diagnosis.
ECG: Trifascicular Block
A 73-year-old male presented with dizziness for 1 year and chest pain for 2 days. His ECG showed left bundle branch block (LBBB) and first-degree atrioventricular block, consistent with possible trifascicular block. Trifascicular block must be confirmed with bundle of His electrogram. The patient has abnormal conduction through one or more divisions of the intraventricular conduction system distal to the bundle of His, presenting as LBBB and first-degree AV block. This suggests involvement of the left and right bundles as well as the AV node, consistent with trifascicular block.
ECG: Wide Complex Tachycardia
A 22-year-old male presented with acute onset breathlessness, palpitations, and profuse sweating. His ECG showed tachycardia at a rate of 200 bpm with a right bundle branch block pattern. This wide complex tachycardia was determined to be ventricular tachycardia based on Brugada criteria and AVR criteria, including the absence of an RS complex in leads V1-V6, a QRS duration greater than 100 ms, and a ventricular activation-velocity ratio greater than 1. The patient was diagnosed with ventricular tachycardia based on the ECG findings and treated accordingly.
Wide complex tachycardia drneeraj
This document discusses criteria for differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) using electrocardiograms (ECGs) of patients presenting with wide complex tachycardia. It outlines definitions of VT and SVT, as well as diagnostic criteria including Brugada criteria, the lead aVR algorithm, and the RWPT (R wave to peak time) criterion. The document then analyzes ECGs of two case studies, concluding that the first is VT and the second is SVT with aberrant conduction based on application of the discussed criteria. It recognizes Prevost and Batelli for inventing defibrillation in 1899 by discovering electric shocks could
Approach to qrs wide complex tachycardias copy
1) The document discusses the approach to diagnosing wide complex tachycardia, which can be either ventricular tachycardia (VT) originating from the ventricles or supraventricular tachycardia (SVT) with aberrant conduction.
2) Key ECG findings that suggest VT include right axis deviation, concordance, fusion/capture beats, and AV dissociation. Wider QRS duration (>140ms for RBBB, >160ms for LBBB) also favors VT.
3) SVT with aberrancy is suggested by consistent P wave timing, short RP intervals, and termination with vagal maneuvers. Pre-excited SVT can also present as wide complex
Ventricular tachycardia
Ventricular tachycardia (VT) is an arrhythmia originating in the ventricles with a heart rate over 100 beats per minute and wide QRS complexes of at least 120 ms. VT can be either idiopathic or structural, sustained or non-sustained, and monomorphic or polymorphic. The ECG can diagnose VT based on the wide QRS complexes. VT has subtypes including bundle branch reentry VT and idiopathic monomorphic VT. Treatment options include medical therapies like amiodarone, implantable cardioverter defibrillators based on major trials, and catheter ablation.
ECG: Coronary Sinus Rhythm
The patient presented with chest pain for 3 hours and a history of hypertension. An ECG showed an atrial rhythm originating from the coronary sinus with a heart rate of 100 bpm and inverted P waves in leads II, III, and aVF. The diagnosis was a coronary sinus rhythm with an inferior-posterior wall myocardial infarction based on ST elevations in leads II, III, and aVF with T wave inversions and ST depressions in leads V2-V4.
Ecg quiz
This document contains a quiz with multiple choice questions about ECG interpretations. Some key findings included in the questions are right bundle branch block with left posterior hemiblock, third degree atrioventricular block, left bundle branch block with Cabrera's sign indicating possible myocardial infarction, Wolff-Parkinson-White syndrome type A, ventricular tachycardia, atrial fibrillation, premature ventricular contractions, left ventricular hypertrophy, anterior myocardial infarction, hyperkalemia, and more. The document also includes explanations of ECG patterns and signs such as bundle branch blocks, ventricular tachycardia criteria, Wellens' phenomenon, hyperacute T waves, and more.
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.
Stepwise interpretation ECG #12
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape pacemaker was in the AV junction, resulting in an escape junctional rhythm driving the ventricles. The ECG was otherwise normal.
ECG: Atrial Flutter
Daniel, a 50-year-old male, presented with palpitations and chest pain for 2 hours. His ECG showed atrial flutter with an atrial rate of 300 beats/min and a 4:1 heart rate of 75 beats/min, indicating incomplete right bundle branch block. Atrial flutter is a macro-reentrant arrhythmia involving a reentrant pathway, most commonly in the cavo-tricuspid isthmus. ECG findings include sawtooth-shaped flutter waves and a constant atrial rate of around 300 beats/min. Treatment involves cardioversion, anticoagulation, antiarrhythmic drugs, or catheter ablation of the reentrant pathway.
Atrial flutter (AFl) – management principals
Atrial flutter- an uncommon arrhythmia and understanding of its pathophysiology, types and treatment options...
Atrial fibrillation & Atrial flutter
Atrial fibrillation and atrial flutter are types of arrhythmia where the heart beats irregularly. Atrial fibrillation occurs when rapid, irregular electrical signals cause the heart's upper chambers (atria) to beat very fast and irregularly. Atrial flutter is similar but the heart beats fast in a regular pattern. These conditions are diagnosed through electrocardiograms which detect abnormal heart rhythms. Holter monitors and event recorders can also detect arrhythmias over longer periods of time when symptoms occur. Complications include stroke and heart failure, so treatment focuses on rate or rhythm control and preventing clots.
Anatomy of Cardiac Conduction System
This document summarizes the anatomy of the cardiac conduction system. It describes the locations and functions of the key components, including the sinus node, atrioventricular node, bundle of His, bundle branches, and Purkinje fibers. It also discusses the histological characteristics that define the conduction system and how impulses are conducted through each component to coordinate ventricular depolarization.
The cardiac conduction_system
The document summarizes the flow of blood through the four chambers of the heart. It describes how deoxygenated blood enters the right atrium from the superior and inferior vena cava and coronary sinus. It then flows to the right ventricle through the tricuspid valve and is pumped to the lungs through the pulmonary valve to become oxygenated. Oxygenated blood returns to the left atrium via the pulmonary veins and flows to the left ventricle through the bicuspid valve to be pumped out to the body through the aorta. The blood then circulates through the arteries and returns deoxygenated to the heart through the veins to repeat the cycle.
Origin and spread of cardiac impulse, pacemaker, conducting system of heart, ...
The document discusses the cardiac impulse and conduction system of the heart. It notes that the heartbeat originates from the sinus node, which acts as the natural pacemaker at a rate of 70-80 beats per minute. The impulse then spreads through the atrioventricular node and Purkinje fibers to contract the atria and ventricles in sequence. The conduction rates vary in different cardiac tissues. The sinus node controls the heartbeat under normal conditions, but abnormal pacemakers can develop elsewhere in rare cases. The conduction system ensures coordinated contraction of the heart chambers to effectively pump blood.
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wide complex tachycardia
This document summarizes an ECG of a 55-year-old male patient presenting with palpitations. The initial ECG shows a wide complex tachycardia. Differential diagnoses include ventricular tachycardia or supraventricular tachycardia with aberrancy. ECG features favoring ventricular tachycardia over supraventricular tachycardia are discussed, including Brugada criteria and the lead AVR algorithm. Analysis of the patient's ECG determines the rhythm is ventricular tachycardia with left bundle branch block morphology based on his history of myocardial infarction.
ECG: Atrial Infarct
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.
ECG: Quiz
This document contains ECG readings and descriptions of various cardiac conditions including: multifocal atrial tachycardia, atrial flutter with 2:1 AV block, paroxysms of atrial tachycardia, ventricular tachycardia with AV dissociation, inferior wall myocardial infarction, sinus rhythm with atrial ectopics and complete heart block, acute inferior myocardial infarction, polymorphic ventricular tachycardia, and wide complex tachycardia suggestive of left anterior descending artery involvement. The document aims to teach identification of cardiac conditions based on ECG features.
ECG #12 - ID 111 - CHB
This document discusses the stepwise interpretation of an ECG for a patient. It identifies that the patient, a 56-year-old man who had an episode of syncope, has sinus rhythm with complete heart block. The atrial rate is 80/min while the ventricular rate is 43/min, showing dissociation between the two rhythms. The QRS complexes originate from the AV junction at a rate of 43/min, indicating an escape junctional rhythm. The final diagnosis is sinus rhythm with complete heart block and an escape junctional rhythm supplying the ventricles.
Stepwise interpretation of ECG - #12 no Dx ID111
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape pacemaker was in the AV junction, resulting in an escape junctional rhythm controlling the ventricles. The ECG was otherwise normal.
Wide Complex Tachycardia
This document discusses the differential diagnosis and evaluation of wide complex tachycardia. It lists the main differential diagnoses as ventricular tachycardia, supraventricular tachycardia with pre-existing conduction abnormalities, supraventricular tachycardia with aberrant conduction, electrolyte abnormalities, or conduction over an accessory pathway. When in doubt, it is safest to assume it is ventricular tachycardia, especially in patients with cardiovascular disease. The document outlines criteria to consider in the history and examination and ECG features that can help differentiate ventricular tachycardia from supraventricular tachycardia.
Wide complex tachycardia
This document discusses wide complex tachycardias and how to differentiate them based on electrocardiogram (ECG) findings. It provides details on what makes a complex narrow or wide, types of wide complex tachycardias including ventricular tachycardia and supraventricular tachycardia, and ECG criteria to help determine the source and mechanism such as the presence or absence of RS complexes and their intervals. Morphologic criteria on the ECG and algorithms like the ACC algorithm are presented to aid in differential diagnosis.
ECG: Trifascicular Block
A 73-year-old male presented with dizziness for 1 year and chest pain for 2 days. His ECG showed left bundle branch block (LBBB) and first-degree atrioventricular block, consistent with possible trifascicular block. Trifascicular block must be confirmed with bundle of His electrogram. The patient has abnormal conduction through one or more divisions of the intraventricular conduction system distal to the bundle of His, presenting as LBBB and first-degree AV block. This suggests involvement of the left and right bundles as well as the AV node, consistent with trifascicular block.
ECG: Wide Complex Tachycardia
A 22-year-old male presented with acute onset breathlessness, palpitations, and profuse sweating. His ECG showed tachycardia at a rate of 200 bpm with a right bundle branch block pattern. This wide complex tachycardia was determined to be ventricular tachycardia based on Brugada criteria and AVR criteria, including the absence of an RS complex in leads V1-V6, a QRS duration greater than 100 ms, and a ventricular activation-velocity ratio greater than 1. The patient was diagnosed with ventricular tachycardia based on the ECG findings and treated accordingly.
Wide complex tachycardia drneeraj
This document discusses criteria for differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) using electrocardiograms (ECGs) of patients presenting with wide complex tachycardia. It outlines definitions of VT and SVT, as well as diagnostic criteria including Brugada criteria, the lead aVR algorithm, and the RWPT (R wave to peak time) criterion. The document then analyzes ECGs of two case studies, concluding that the first is VT and the second is SVT with aberrant conduction based on application of the discussed criteria. It recognizes Prevost and Batelli for inventing defibrillation in 1899 by discovering electric shocks could
Approach to qrs wide complex tachycardias copy
1) The document discusses the approach to diagnosing wide complex tachycardia, which can be either ventricular tachycardia (VT) originating from the ventricles or supraventricular tachycardia (SVT) with aberrant conduction.
2) Key ECG findings that suggest VT include right axis deviation, concordance, fusion/capture beats, and AV dissociation. Wider QRS duration (>140ms for RBBB, >160ms for LBBB) also favors VT.
3) SVT with aberrancy is suggested by consistent P wave timing, short RP intervals, and termination with vagal maneuvers. Pre-excited SVT can also present as wide complex
Ventricular tachycardia
Ventricular tachycardia (VT) is an arrhythmia originating in the ventricles with a heart rate over 100 beats per minute and wide QRS complexes of at least 120 ms. VT can be either idiopathic or structural, sustained or non-sustained, and monomorphic or polymorphic. The ECG can diagnose VT based on the wide QRS complexes. VT has subtypes including bundle branch reentry VT and idiopathic monomorphic VT. Treatment options include medical therapies like amiodarone, implantable cardioverter defibrillators based on major trials, and catheter ablation.
ECG: Coronary Sinus Rhythm
The patient presented with chest pain for 3 hours and a history of hypertension. An ECG showed an atrial rhythm originating from the coronary sinus with a heart rate of 100 bpm and inverted P waves in leads II, III, and aVF. The diagnosis was a coronary sinus rhythm with an inferior-posterior wall myocardial infarction based on ST elevations in leads II, III, and aVF with T wave inversions and ST depressions in leads V2-V4.
Ecg quiz
This document contains a quiz with multiple choice questions about ECG interpretations. Some key findings included in the questions are right bundle branch block with left posterior hemiblock, third degree atrioventricular block, left bundle branch block with Cabrera's sign indicating possible myocardial infarction, Wolff-Parkinson-White syndrome type A, ventricular tachycardia, atrial fibrillation, premature ventricular contractions, left ventricular hypertrophy, anterior myocardial infarction, hyperkalemia, and more. The document also includes explanations of ECG patterns and signs such as bundle branch blocks, ventricular tachycardia criteria, Wellens' phenomenon, hyperacute T waves, and more.
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.
Stepwise interpretation ECG #12
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape pacemaker was in the AV junction, resulting in an escape junctional rhythm driving the ventricles. The ECG was otherwise normal.
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ECG: Atrial Flutter
Daniel, a 50-year-old male, presented with palpitations and chest pain for 2 hours. His ECG showed atrial flutter with an atrial rate of 300 beats/min and a 4:1 heart rate of 75 beats/min, indicating incomplete right bundle branch block. Atrial flutter is a macro-reentrant arrhythmia involving a reentrant pathway, most commonly in the cavo-tricuspid isthmus. ECG findings include sawtooth-shaped flutter waves and a constant atrial rate of around 300 beats/min. Treatment involves cardioversion, anticoagulation, antiarrhythmic drugs, or catheter ablation of the reentrant pathway.
Atrial flutter (AFl) – management principals
Atrial flutter- an uncommon arrhythmia and understanding of its pathophysiology, types and treatment options...
Atrial fibrillation & Atrial flutter
Atrial fibrillation and atrial flutter are types of arrhythmia where the heart beats irregularly. Atrial fibrillation occurs when rapid, irregular electrical signals cause the heart's upper chambers (atria) to beat very fast and irregularly. Atrial flutter is similar but the heart beats fast in a regular pattern. These conditions are diagnosed through electrocardiograms which detect abnormal heart rhythms. Holter monitors and event recorders can also detect arrhythmias over longer periods of time when symptoms occur. Complications include stroke and heart failure, so treatment focuses on rate or rhythm control and preventing clots.
Anatomy of Cardiac Conduction System
This document summarizes the anatomy of the cardiac conduction system. It describes the locations and functions of the key components, including the sinus node, atrioventricular node, bundle of His, bundle branches, and Purkinje fibers. It also discusses the histological characteristics that define the conduction system and how impulses are conducted through each component to coordinate ventricular depolarization.
The cardiac conduction_system
The document summarizes the flow of blood through the four chambers of the heart. It describes how deoxygenated blood enters the right atrium from the superior and inferior vena cava and coronary sinus. It then flows to the right ventricle through the tricuspid valve and is pumped to the lungs through the pulmonary valve to become oxygenated. Oxygenated blood returns to the left atrium via the pulmonary veins and flows to the left ventricle through the bicuspid valve to be pumped out to the body through the aorta. The blood then circulates through the arteries and returns deoxygenated to the heart through the veins to repeat the cycle.
Origin and spread of cardiac impulse, pacemaker, conducting system of heart, ...
The document discusses the cardiac impulse and conduction system of the heart. It notes that the heartbeat originates from the sinus node, which acts as the natural pacemaker at a rate of 70-80 beats per minute. The impulse then spreads through the atrioventricular node and Purkinje fibers to contract the atria and ventricles in sequence. The conduction rates vary in different cardiac tissues. The sinus node controls the heartbeat under normal conditions, but abnormal pacemakers can develop elsewhere in rare cases. The conduction system ensures coordinated contraction of the heart chambers to effectively pump blood.
The heart conduction system
The document contains information about labeling the parts of the heart and the cardiac output. It defines cardiac output as the amount of blood pumped by the heart per minute, which is calculated by multiplying heart rate by stroke volume. It then provides an example calculation of a person's cardiac output. The document also describes the conduction system of the heart, noting that the sinoatrial node acts as the pacemaker and the atrioventricular node relays electrical impulses to allow for coordinated contraction of the atria and ventricles.
Cardiac arrythmias
This document discusses cardiac arrhythmias and the cardiac conduction system. It describes the sinoatrial node, atrioventricular node, and Purkinje fibers, which make up the cardiac conduction system. Causes of arrhythmias include enhanced automaticity, triggered activity, and re-entry. Various arrhythmias are described including sinus bradycardia, premature atrial contractions, atrial fibrillation, premature ventricular contractions, ventricular tachycardia, and different types of atrioventricular block. The electrocardiogram is discussed as a tool to evaluate heart rate, intervals, waves, and diagnose arrhythmias.
Conduction system of heart
This document provides an overview of the conduction system of the heart. It begins with the development of the primitive cardiac tube and differentiation of heart structures. It then describes the specialized conduction tissues including the sinoatrial node, atrioventricular node, bundle of His, bundle branches, and Purkinje fibers. It discusses impulse conduction through the heart and characteristics of cardiac conduction cells. Finally, it covers conduction defects, implications for congenital heart anomalies like ASD and VSD, and considerations for cardiac surgery.
Cardiac conduction system
The cardiac conduction system is made up of four main structures that stimulate contraction of the heart muscle in a coordinated way. The sinoatrial node acts as the pacemaker and initiates electrical impulses throughout the heart. The atrioventricular node receives impulses from the atria and slows conduction to allow for proper atrial contraction before ventricular contraction. Impulses then travel through the atrioventricular bundle and Purkinje fibers to coordinate simultaneous contraction of the ventricles. An electrocardiogram is used to measure the electrical activity of the heart and detect any abnormalities.
Arrhythmias general
The document discusses various types of arrhythmias and their mechanisms. It describes ectopic beats that originate from locations other than the sinoatrial node, and explains that they can cause single beats or take over the heart rhythm. The mechanisms of arrhythmias include altered automaticity, triggered activity, and reentry. Reentry involves unidirectional block and different conduction speeds that allow an impulse to circulate and repeat, creating a reentrant circuit. The document outlines several specific types of arrhythmias like atrial fibrillation, atrial flutter, atrioventricular nodal reentry, and Wolff-Parkinson-White syndrome.
Arrhythmia diagnosis and management
This document provides an overview of various types of arrhythmias including their typical presentation, underlying causes, characteristic ECG patterns, and treatment approaches. Key types are discussed such as sinus tachycardia, atrial fibrillation, various degrees of heart block, premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, and asystole. For each, the rate, P wave, QRS complex, conduction, and rhythm are defined and potential causes and management strategies are outlined. The document serves as a guide for clinicians in identifying and treating different cardiac arrhythmias.
Conduction System of the Heart
The conduction system of the heart is initiated by the sinoatrial node, which acts as the dominant pacemaker. It is located in the junction of the right atrium and superior vena cava and is innervated by the parasympathetic and sympathetic nervous systems. Conduction then proceeds through the atrioventricular node, which slows conduction to allow for ventricular filling, and the bundle of His divides into left and right bundle branches to stimulate the ventricles.
Cardiac arrhythmias
- The document discusses the anatomy and physiology of the heart's conduction system and how it generates the normal cardiac rhythm. It describes the roles of the sinoatrial node, atrioventricular node, Bundle of His, and Purkinje fibers in conducting electrical impulses through the heart.
- Various types of cardiac arrhythmias are defined based on disruptions to the heart's normal conduction system. These include premature beats, rhythms originating from the atria, AV junction, or ventricles. Characteristics like P wave presence/morphology, rate, and regularity are used to identify arrhythmias.
- A 12-lead electrocardiogram (EKG or ECG) is used to
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Origin and spread of cardiac impulse, pacemaker, conducting system of heart, ...
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ECG #10 - ID122 - Atrial Flutter
This document describes the stepwise interpretation of ECG ID 122, which shows atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute in a 50-year-old man complaining of palpitations. The interpretation examines the P waves, QRS complex, QRS duration, signs of ventricular hypertrophy or myocardial infarction, and T waves. The final diagnosis is atrial flutter with variable AV block and a ventricular rate of 107 beats per minute.
Stepwise interpretation of ECG - #10 no Dx ID594
A 50-year-old man presented with palpitations. An ECG showed atrial flutter with a ventricular rate of 107 beats per minute and variable atrioventricular block. The QRS complex was normal in axis and duration with no signs of bundle branch block, ventricular hypertrophy, or prior myocardial infarction. The T waves were normal except in inferior leads and V6 where the saw-tooth pattern of atrial flutter made assessment difficult. The final diagnosis was atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute.
Stepwise interpretation ECG #10
A 50-year-old man presented with palpitations. An ECG showed atrial flutter with a variable atrioventricular block and a ventricular rate of 107 beats per minute. The QRS complex was normal in axis and duration with no signs of right or left bundle branch block, ventricular hypertrophy, or prior myocardial infarction. The T waves were normal except in the inferior leads and V6 where the saw-tooth pattern of atrial flutter made assessment difficult.
Stepwise interpretarion ECG #10
A 50-year-old man presented with palpitations. An ECG showed atrial flutter with a ventricular rate of 107 beats per minute and variable atrioventricular block. The QRS complex was normal in axis and duration with no signs of ventricular hypertrophy or prior myocardial infarction. Due to the saw-tooth pattern of atrial flutter waves, the T waves were difficult to assess in the inferior leads and V6.
Stepwise interpretation of ECG - #12 no Dx ID111
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape rhythm was originating from the AV junction. The final diagnosis was sinus rhythm with complete heart block and an escape junctional rhythm at a ventricular rate of 43/min.
Stepwise interpretation of ECG - #14 no Dx ID123
A 67-year-old woman presented with palpitations. Her ECG showed a narrow-QRS tachycardia of 160 beats per minute. P waves were visible and preceded the QRS complexes, with a PR interval of 140 msec. The arrhythmia was diagnosed as atrial tachycardia based on the P wave morphology and timing.
Stepwise interpretation of ECG - #14 no Dx ID123
A 67-year-old woman presented with palpitations. Her ECG showed a narrow-QRS tachycardia at a rate of 160 beats per minute. P waves were visible and preceded the QRS complexes, with negative P waves in leads II, III, aVF, and V3-V6. The PR interval was 140 milliseconds. Based on these characteristics, the patient was diagnosed with atrial tachycardia. Additional analysis found a normal QRS axis and duration, no ventricular hypertrophy, no signs of infarction, and normal T waves.
Stepwise interpretation of ECG - #12 no Dx ID111
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape rhythm was originating from the AV junction. The final diagnosis was sinus rhythm with complete heart block and an escape junctional rhythm at a ventricular rate of 43/min.
Stepwise interpretation of ECG - #912 no Dx ID111
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape pacemaker was in the AV junction, resulting in an escape junctional rhythm controlling the ventricles. The ECG was otherwise normal.
Stepwise interpretation of ECG ID123
A 67-year-old woman presented with palpitations. An ECG showed a narrow-QRS tachycardia at a rate of 160 beats per minute, with visible P waves preceding each QRS complex. The P waves were negative in leads II, III, aVF and V3-V6, with a PR interval of 140 msec. The diagnosis was determined to be atrial tachycardia based on the ECG findings.
ECG #14 - ID 123 - Atrial Tachycardia
A 67-year-old woman presented with palpitations. An ECG showed a narrow-QRS tachycardia at a rate of 160 beats per minute, with visible P waves preceding each QRS complex. The P waves were negative in leads II, III, aVF and V3-V6, with a PR interval of 140 msec. Based on these characteristics, the patient was diagnosed with atrial tachycardia originating from the atria.
Stepwise interpretation of ECG - #08 no Dx ID478
This document describes the stepwise interpretation of an ECG for a 58-year-old man with dilated cardiomyopathy. It was determined that the patient has normal sinus rhythm at a rate of 97 beats per minute, evidence of biatrial enlargement, left ventricular hypertrophy, and repolarization abnormality but no signs of myocardial infarction.
Stepwise interpretation of ECG ID175
A 58-year-old man with coronary artery disease was followed in the Cardiac Clinic. An electrocardiogram found normal sinus rhythm at 88 beats per minute with left bundle branch block, evidenced by a prolonged QRS duration of 145 milliseconds and abnormal depolarization that can mask other conditions.
Stepwise interpretation of ECG - #05 no Dx ID175
A 58-year-old man with a history of coronary artery disease presented with an ECG showing normal sinus rhythm of 88 beats per minute. The ECG revealed left bundle branch block, evidenced by a prolonged QRS duration of 145 milliseconds with characteristic morphology. Left bundle branch block can mask signs of left ventricular hypertrophy and prior myocardial infarction. It is also associated with secondary repolarization abnormalities like ST depression and negative T waves in leads with broad R waves. The final diagnosis was normal sinus rhythm with left bundle branch block.
Stepwise interpretation of ECG - #5 no Dx ID175
A 58-year-old man with a history of coronary artery disease presented with an ECG showing normal sinus rhythm of 88 beats per minute. The ECG revealed left bundle branch block, evidenced by a prolonged QRS duration of 145 milliseconds with characteristic morphology. Left bundle branch block can mask signs of left ventricular hypertrophy and prior myocardial infarction. It is also associated with secondary repolarization abnormalities like ST depression and negative T waves in leads with broad R waves. The final diagnosis was normal sinus rhythm with left bundle branch block.
Stepwise interpretation ECG #5
A 58-year-old man with a history of coronary artery disease presented with normal sinus rhythm of 88 beats per minute and left bundle branch block. Left bundle branch block was diagnosed due to the prolonged QRS duration of 145 milliseconds with characteristic morphology. The presence of left bundle branch block can mask signs of left ventricular hypertrophy and prior myocardial infarction on electrocardiogram. Abnormal repolarization is also commonly seen in the form of ST depression and negative T waves in leads with broad R waves in left bundle branch block.
Stepwise interpretation of ECG - #5 no Dx ID659
A 58-year-old man with a history of coronary artery disease presented with an ECG showing normal sinus rhythm of 88 beats per minute. The ECG revealed left bundle branch block, evidenced by a prolonged QRS duration of 145 milliseconds with characteristic morphology. Left bundle branch block can mask signs of left ventricular hypertrophy and prior myocardial infarction. It is also associated with secondary repolarization abnormalities like ST depression and negative T waves in leads with broad R waves. The final diagnosis was normal sinus rhythm with left bundle branch block.
SVT-Alogarythm
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ECG#8 - ID478 - LVH BAE
The document discusses an ECG reading of a 58-year-old man with dilated cardiomyopathy. It finds evidence of biatrial enlargement from enlarged P waves and left ventricular hypertrophy shown by a widened QRS complex and ST abnormality, with a heart rate of 97 beats per minute and no signs of myocardial infarction.
ECG4.pdf
This document summarizes different types of cardiac rhythms as observed on an ECG monitor:
1. Normal sinus rhythm and sinus tachycardia involve the sinus node firing regularly at rates between 60-100 bpm or over 100 bpm respectively, with normal conduction through the ventricles.
2. Atrial fibrillation involves rapid, irregular firing of the atria so that only some impulses conduct to the ventricles, appearing irregular on the ECG.
3. Ventricular tachycardia involves an irritable focus in the ventricles overriding the normal pacemaker and firing regularly at 150-250 bpm, appearing without P waves on the ECG.
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ECG #13 - ID 419 - EAR IRBBB
This ECG shows an ectopic atrial rhythm originating from a low atrial region at a rate of 70 beats per minute, as well as an incomplete right bundle branch block. P waves are clearly seen and negative in several leads, with a PR interval of 180ms indicating the rhythm is not junctional. The QRS axis is normal and duration is 100ms with an rSR' pattern consistent with incomplete right bundle branch block. The final diagnosis is an ectopic atrial rhythm at 70bpm with incomplete right bundle branch block.
ECG #11 - ID 108 - 2nd degree AV block
This document summarizes the ECG findings for a 58-year-old man presenting to the emergency department with 2nd degree AV block, Mobitz type 1. The ECG shows regular sinus rhythm at a rate of 88 beats per minute with intermittent conduction block such that every third P-wave is not followed by a QRS complex, resulting in a ventricular rate of 59 beats per minute. Further analysis of the ECG found normal QRS axis, duration and morphology with no signs of infarction, hypertrophy, or other abnormalities. The final diagnosis was sinus rhythm with Mobitz type 1 2nd degree AV block and a ventricular rate of 58 beats per minute.
ECG #9 - ID594a - acute ASMI
This ECG shows signs of an acute antero-septal myocardial infarction in a 49-year old man presenting with chest pain, requiring urgent therapy. The ECG reveals normal sinus rhythm, a normal QRS axis and duration, and marked ST elevation in leads V1-V4, consistent with an antero-septal injury pattern diagnostic of an acute antero-septal infarction.
ECG #7 - ID 279 - RVH
This ECG belongs to a 57-year-old woman with a history of rheumatic fever and recent symptoms of severe dyspnea and fatigue. The ECG shows normal sinus rhythm, left atrial enlargement, right axis deviation, and right ventricular hypertrophy. There are also ST depressions and negative T waves that may indicate ischemia from heart failure.
ECG #6 - ID 168 LVH
The document summarizes the stepwise interpretation of an ECG for a 78-year-old woman with a heart murmur. It finds sinus rhythm at 77 beats per minute with sinus arrhythmia and first-degree AV block. There is also evidence of left ventricular hypertrophy with ST-T abnormalities and no signs of myocardial infarction.
ECG #2 - ID 352 - Premature Atrial Complexes
A 62-year-old man presented with palpitations. An analysis of his ECG found sinus rhythm at 83 bpm with premature atrial complexes, where every third P wave was premature in a pattern of trigeminy. The QRS complexes, ST segments, and T waves were normal with no signs of right or left atrial enlargement, bundle branch blocks, ventricular hypertrophy, or myocardial infarction. The final diagnosis was sinus rhythm with atrial premature complexes in a pattern of trigeminy, but an otherwise normal ECG.
ECG #1 - ID 380 – Normal ECG
The ECG is for a 53-year-old man undergoing pre-anesthesia evaluation. The interpreter found normal sinus rhythm at a rate of 60 bpm, normal P waves and PR interval, normal QRS axis and duration with no evidence of conduction blocks, no signs of chamber enlargement or hypertrophy, and normal ST segments and T waves. The final diagnosis was a normal ECG.
ECG #5 - ID 168 - Left bundle branch block
A 58-year-old man followed for coronary artery disease presented with an ECG showing sinus rhythm at 88 beats per minute, a prolonged QRS duration of 145 milliseconds consistent with left bundle branch block, and no evidence of right or left ventricular hypertrophy or atrial enlargement. The left bundle branch block precludes diagnosing left ventricular hypertrophy and can mask underlying myocardial infarction.
ECG #4 - ID 383 – Atrial fibrillation
A 76-year-old woman underwent an ECG examination in her family doctor's office which showed atrial fibrillation with an irregularly irregular ventricular rhythm of 66 beats per minute and no P waves. The QRS complexes were normal with no signs of conduction abnormalities, ventricular hypertrophy, or prior myocardial infarction. The final diagnosis was atrial fibrillation with a controlled ventricular rate of 66 bpm and no other abnormalities.
ID 352 –Sinus rhythm With premature atrial complex
A 62-year-old man presented with palpitations. An analysis of his ECG found sinus rhythm at 83 bpm with premature atrial complexes, where every third P wave was premature in a pattern of trigeminy. The ECG further showed normal P waves, QRS axis, duration and complexes, as well as normal ST segments and T waves. The final diagnosis was sinus rhythm with atrial premature complexes in a pattern of trigeminy, but an otherwise normal ECG.
Atrio-ventricular dissociation
Atrio-ventricular dissociation occurs when the atrial and ventricular rhythms are independent of each other. It can happen when the atrial rate slows below the intrinsic ventricular rate, or due to inappropriate acceleration of the ventricular rate. Typically in AV dissociation the distal pacemaker, such as the ventricles, beats faster than the proximal pacemaker like the atria. In complete heart block the proximal pacemaker usually beats faster than the distal one. However, there are exceptions to using pacemaker rates to distinguish the two.
Lead errors: reversal of limb leads
This document discusses common errors involving limb leads in electrocardiograms (ECGs), including:
1) Lead reversal is a common error, such as switching the right and left arm leads. This can cause leads like aVR and aVL to be reversed.
2) Misplacing the ground cable, such as attaching it to the right arm instead of the right leg, is another error.
3) Complex misplacements of the limb leads are less common. Examples provided demonstrate how specific lead errors can cause abnormalities to appear or disappear on ECG tracings.
Stepwise interpretation of ECG - #9 no Dx ID 594
This ECG shows a 49-year-old man experiencing severe chest pain for 1 hour who is presenting with an antero-septal injury pattern consistent with an acute myocardial infarction requiring urgent therapy. The ECG shows normal sinus rhythm at 84 beats per minute, a normal PR interval and QRS axis, and no signs of ventricular hypertrophy. It does reveal marked ST elevation in leads V1-V4, confirming the diagnosis of an acute antero-septal infarction.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm originating outside the sinoatrial node at a rate of 75 beats per minute. The P waves precede each QRS complex but have an abnormal axis. There is also evidence of incomplete right bundle branch block seen by a widened QRS complex with a duration of 100 milliseconds and rSR' pattern. The final diagnosis is an ectopic atrial rhythm at 75 bpm with incomplete right bundle branch block and no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm originating outside the sinoatrial node at a rate of 75 beats per minute. The P waves have an abnormal axis and precede each QRS complex, indicating the atrial origin. There is also an incomplete right bundle branch block seen by the prolonged QRS duration of 100 milliseconds and rSR' pattern. The final diagnosis is an ectopic atrial rhythm at a rate of 75 bpm with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm at a rate of 70 beats per minute with an incomplete right bundle branch block pattern. The QRS axis is normal and the duration is 100 msec. with an rSR' configuration. There are no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves. The final diagnosis is an ectopic atrial rhythm at 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm at a rate of 70 beats per minute with an incomplete right bundle branch block pattern. The QRS axis is normal and the duration is 100 msec. with an rSR' configuration. There are no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves. The final diagnosis is an ectopic atrial rhythm at 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
Ectopic atrial rhythm at a rate of 75 beats per minute. P waves are clearly seen and negative in several leads, indicating they do not originate from the sinus node but likely a low atrial region. There is also an incomplete right bundle branch block present as shown by a prolonged QRS duration of 100 milliseconds with an rSR' pattern. The final diagnosis is an ectopic atrial rhythm at a rate of 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
Ectopic atrial rhythm at a rate of 75 beats per minute. P waves are clearly seen and negative in several leads, indicating they do not originate from the sinus node but likely a low atrial region. There is also an incomplete right bundle branch block present as shown by a widened QRS duration of 100 milliseconds with an rSR' pattern. The final diagnosis is an ectopic atrial rhythm at a rate of 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID419
The ECG shows an ectopic atrial rhythm originating from a low atrial region at a rate of 70 beats per minute, as well as an incomplete right bundle branch block. P waves are abnormal in shape and timing. There are no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves.
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Stepwise interpretation of ECG ID122
- 1. Stepwise interpretation of ECG ID 122 Atrial Flutter
- 2. ID 122 – 50 year old man complaining of palpitation
- 3. ID 122 – 50 year old man complaining of palpitation Can you see P waves?
- 4. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. We can see typical waves of atrial flutter with variable AV block – ventricular rate = 107/min.
- 5. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. Let’s now look at the QRS complexes: The QRS complex is positive in I and its average is slightly positive or isoelectric in aVF – The QRS is normal
- 6. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. The QRS duration is normal – There are no signs of right or left bundle branch block Or nonspecific block
- 7. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. There no signs of right or left ventricular hypertrophy
- 8. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. The QRS shows no signs of myocardial infarction
- 9. ID 122 – Atrial flutter with variable AV block – Ventricular rate 107/min. Because of the saw-like waves of atrial flutter, it is difficult to assess the T waves in the Inferior leads and V6. In the other leads the T waves are normal.
- 10. ID 122 - Final diagnosis - Atrial flutter with variable AV block – Ventricular rate 107/min. Because of the saw-toothed waves of atrial flutter, it is difficult to assess the T waves in the inferior leads and V6. In the other leads the T waves are normal.