12 Lead ECG Interpretation Course by Dr. Vernon Stanley Course Overview
FREE 12-Lead ECG Interpretation Tracing of the Week
Tracing #21    [ Scroll down to submit answer ]
You are an emergency physician at a 25-bed critical access hospital. It is 0300 hrs and the ICU nurse has asked you to interpret and advise treatment regarding the 73-year-old male below with acute onset chest heaviness.
Tracing of the Week (Tracing #21)
A..... Non-specific diffuse ST-elevation and depression most likely representing a combination of digitalis effect and a benign normal variant (early repolarization).
B..... T-wave inversion in lead avR probably related to limb reversal.
C..... ST elevation (coving, plateauing) in Leads II, III, avF, V6 and V5 suspicious of acute ST elevation MI. Ask to see the old tracing for comparison.
D..... Prolonged QT interval (QT > 1/2 RR). The patient is at risk for Ventricular Tachycardia ---------> Ventricular Fibrillation and should be scheduled for an automatic implantable defibrillator.
E..... Subtle ST depressions Leads V1, V2 and avL consistent with ST depressions of reciprocity, but might be non-specific. Ask to see the old tracing for comparison.
F..... Small height P-waves in Leads II, III and avF are virtually diagnostic of right atrial enlargement. Highly suspicious of acute pulmonary embolus.
G.... ST elevation in Leads II, III, avF, V6 and V5 with ST depressions in Leads avL, V1, V2 is virtually diagnostic of the acute pulmonary embolus.
H..... C and E only.
I..... F and G only.
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