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Archive for February 2017

ECG of the Week 6 March 2017

A 19 yo male, University student presents with stabbing chest pain, with a pleuritic component. The pain radiates down his left arm. The pain started last evening but subsided, but has recurred again this morning, so he presents at 10 hours post pain onset to the emergency department. The ECG is shown below. Please describe…

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ECG of the week 22 Februrary 2017

A 23 year old male presents with 6 hours of central sharp chest pain, left arm heaviness and diaphoresis. He has no past medical history or relevant family history. He doesn’t smoke and is a social drinker. He denies any elicit substances. His vitals are: HR as per ECG, BP 128/67, Sats 97% on RA.…

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The ECG’s of Pulmonary Embolism

Let me start by saying that some pulmonary embolisms(PE)’s are obvious. In those, you don’t need pulmonary embolism ECG findings to make the diagnosis. I recently was shown an ECG and asked what the patient’s diagnosis was. I asked my colleague, what the patient presented with. He replied; “This is a 68 yo woman who…

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Module 7: Intervals

This is simple and straightforward. Look for PR intervals and QT intervals. A prolonged PR interval on its own is not a major issue. It represents a first degree block. However if combined with a left anterior fascicular block and a RBBB, it is a triphasicular block and the patient requires a pacemaker. The QT…

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Module 6: The T wave

In looking at the T wave, there are a few points to memorize: The T wave is usually symmetrical. If not beware that there isn’t a p wave in the ecg. The peaked T wave can represent hyperkalaemia or ischaemia. If the T wave is approaching or has passed the hight of the T wave…

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Module 8: Pacing Spikes

This is the simplest module of them all. Simply look for pacing spikes in all leads. The issue could be a defective pacemaker, or an issue with the pacing leads. If pacing spikes are noticed and the patient has had arrhythmia-like symptoms, then the pacemaker must be interrogated.

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Module 5: The ST-T Segment

The ST-T Segment The first point to make is that the baseline to use when reading the ECG is the T-P Line. This allows you to quickly pick up ST depressions and elevations. The ST changes that can occur, can be ischaemic and in some cases due to arrhythmias. ST Elevation It is imperative to…

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