Got this case 2 days ago and I’m wondering what’s your opinion on the inferior leads and I and aVL. Would you call this a STEMI based on III and aVF...
Probably not just based on this one 12 lead. Whats this guys history? does he have risk factors or family history? How did this pt present? I'd certainly be...
Thank you Christa for your comments. I had a quick glimpse at this patient when she arrived. Female in late 40s with epigastric and left flank pain that...
I thought I was the only one who couldn't tell whether or not there was significant elevation or depression. I'd hesitate to call it a "STEMI" to alert the...
I think it's suspicious, Gustavo. Q waves in III and aVF with straight (non-concave) ST segments in II, III, and aVF, downsloping ST segments in I and aVL, R/S...
I would have to agree with Tom that this is suspicious but not definitive. The Qwaves in the II, III, aVF leads seem to meet the criteria for a prior MI. The...
Before jumping to any type of testing, might I ask what were the symptoms that prompted an EKG? Was it cardiac symptoms, or non-cardiac symptoms, but someone...
Could this be a TCO of the RCA or a Cirx Diag? What is a cirx diag? Â Is TCO total chronic occlusion? Neil ... From: Nikiah Nudell <medicnick@...> To:...
EMTA1497@...
Feb 3, 2008 1:09 am
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The question was not whether there might be Non STEMI or unstable angina that needs further inpatient workup. the question was whether it is STEMI that...
Dr. Smith - What specifically leads you to believe this is a combination of BER and LVH? Best, Tom Bouthillet ... From: Stephen Smith <smith253@...> To:...
this looks like either LVH or "LV aneurysm" (persistent ST elevation after old MI (both of which can also have reciprocal depression between III and aVL)....
There is large voltage in the precordial leads. Acute STEMI has ST elevation AND a T wave that is out of proportion to the preceding QRS or S-wave. This is...
overall I would have to go with IMI/PMI, prox RCA, we have no old ecg to compare, very important in all cases, I don't see massive voltage but there could be...
I think many of us on the EKG Club have been looking at difficult ECGs for > 10 years (some a lot longer). How many years should it take? I was taught, and I...
Hi Neil, Sorry, I was thinking of a total chronic occlusion (TCO) [of the RCA or] of a left dominant circumflex with lesion(s) of a marginal branch(es). Dr....
Hi Erskine, Gustavo provided the symptoms in another posting which led to my suggestion for additional testing. Thank you for the OAT link, that will be useful...
The question here, as I understand it, is whether the patient needs emergent reperfusion. there is no question that the LAD (the artery in question) is open...
Thanks, Dr. Smith. Your paper on T/QRS ratio sounds interesting. I remember reading something about T/QRS ratio with regard to ventricular aneurysm. I was...
hi guys, although I agree with Dr. Smith's note from 2/4 concerning the benefit of "years of experience and pattern recognition" in adequately interpreting the...
the paper you read on LV aneurysm is mine. that's the one I was referring to. (American Journal of Emerg Med 23(3):279-287, May 2005. Dr Matera is greatly...
Hi Dr Smith, Thank you for the reference, if someone has the ability to forward a PDF I would be grateful. Could you clarify for me though what you are meaning...
It absolutely shows it, which is exactly why we perform serial ECGs in the prehospital setting. Dr. Smith is probably involved in the Hennepin County study...
Hi Tom, Yes I completely agree. Just this morning I was in the cath lab and saw this first hand. In another study I have witnessed complete occlusions during...
Hi guys, (1st I am not sure what the first comment below is referring to, an article on LV aneurysm ??, did I miss something ??) anyway I hope Dr. Smith ...
Hello, This email message is a notification to let you know that a file has been uploaded to the Files area of the ekg_club group. File :...
ekg_club@yahoogroups....
Feb 6, 2008 12:36 pm
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I meant that changes from one EKG to the next due to lead placement etc are minimal. If there are changes, they are due to changes in the ischemic state of...
hi guys and gals, 1)non-ACS ecg changes from one ecg to the next can and have been documented and are significant ... changes occurring due to non-standard ecg...
Of course all this can happen, most commonly lead placement. But this is blown way out of proportion. There may very be likely institutional variations in...
Anyway, what was the final diagnosis of the EKG in question????? Anyone know? ... -- Stephen W. Smith, MD Faculty Emergency Physician Hennepin County Medical...
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