Sunday, October 22, 2017

Saturday, October 21, 2017

Multifocal atrial tachycardia

Multifocal atrial tachycardia.  The rate is about 150/min and irregular. There at least three P waves of differing morphology present. In leads aVR and AVL the rhythm has some atrial flutter qualities present.  

Wednesday, October 18, 2017

Tuesday, September 5, 2017

Sinus Bradycardia with Dropped PAC

The rhythm shows sinus bradycardia.  The 5th beat is quickly followed by a non-conducted PAC (seen better in lead II and III).  The 6th complex is followed by a PAC.  


Friday, September 1, 2017

Runs of AIVR in NSTEMI Patient

A 50 year old with hx of hypertension and cocaine abuse.  Experienced chest pain and self treated pain with more cocaine x 3 days before coming to the ED.  TNI 75, CKMB 277, CPK 1611, BUN 11.3, Creatinine 1.59.  Likely acute kidney injury and rhabdo.  Treated with fluids.  Patient having runs of AIVR.  In lead V1 it looks like some dissociated P waves are present.



Thursday, August 17, 2017

Tenoretic Induced Junctional Rhythm

A 57 year old with complaints of weakness, dizziness, and palpations.  Past medical history of TIA and hypertension.  Thinking the medication was "not working," the patient decided to double the dose of the daily dose of Atenolol-Chlorthaladone 50-25 (Tenoretic).  He was admitted with bradycardia and hypotension.  The following rhythms were present upon admission.  He appears to have some initial sinus beats with some AV dissociation and a junctional rhythm with retrograde P waves.

For more information, read the interesting discussion in Dr Smith's ECG Blog:    http://hqmeded-ecg.blogspot.com/2013/05/another-interpretation-of-last-rhythm.html and the ECG Guru Blog: ECG Basics: Junctional Rhythm. https://ecgguru.com/ecg/ecg-basics-junctional-rhythm




Monday, August 14, 2017

Basic EKG Test 71


01. Identify the following rhythm.


02. Identify the following rhythm.

03. Identify the following rhythm.

04. Identify the following rhythm.

05. Identify the following rhythm.

06. Identify the following rhythm.

07. Identify the following rhythm.

08. Identify the following rhythm.

09. Identify the following rhythm.
.
10. Identify the following rhythm.

11 Identify the following rhythm.

12. Identify the following rhythm.

13. Identify the following rhythm.

14. Identify the following rhythm.

15. Identify the following rhythm.

16. Identify the following rhythm.

17. Identify the following rhythm.

18. Identify the following rhythm.

19. Identify the following rhythm.

20. Identify the following rhythm.

21. Identify the following rhythm.

22. Identify the following rhythm.

23. Identify the following rhythm.

24. Identify the following rhythm.

25. Identify the following rhythm.







Answers
01. Sinus bradycardia with bigeminal PVCs
02. Normal sinus rhythm
03. 2nd degree heart block type I
04. Atrial paced
05. Sinus bradycardia with a 1st degree block
06. Torsades de pointes
07. Asystole
08. Ventricular paced with failure to pace
09. First degree block
10. Atrial flutter
11. Sinus bradycardia with an exit block
12. Complete heart block
13. Sinus tachycardia
14. Ventricular paced
15. Ventricular tachycarda
16. Atrial fibrillation
17. Demand ventricular pacing
18. 2nd degree heart block type I
19. AV Pacing
20. Sinus arrhythmia
21. Ventricular fibrillation
22. Sinus rhythm with unifocal PVCs
23. Biventricular pacing
24. Ventricular paced with failure to capture
25. Supraventicular tachycardia

Wednesday, July 26, 2017

Inferior-Posterior MI

A 70 year old with chest pain.  Past history of hypertension,  prostate hypertrophy, and elevated cholesterol.  BP 188/110.  Received ASA, Hydralazine, Brilinta loading dose, and started on heparin drip.  Transferred for PCI. EKG shows ST elevation in leads II, III, aVF.  Reciprocal depression in I and AVL.  ST depression with tall R waves in V1 and V2.   There is sinus bradycardia with a 1st degree block.