Once a month at this site there will appear a new 12-lead electrocardiogram (ECG). Accompanying the ECG will be a clinical vignette relevant to the tracing and one or two questions for you to answer. The tracings will be classified by their interpretive difficulty:
Basic: The ECG represents a basic clinical problem or basic ECG principle. Should be mastered by a graduating medical student.
Intermediate: The ECG presents a more challenging or complex problem. Should be able to be mastered by most graduating Family Practice, Medicine or Emergency Medicine residents.
Advanced: Presents a complex, subtle or advanced ECG concept. Physicians with a special interest in ECG’s or Cardiology fellows should find these tracings interesting.
The Answers and Follow up will be posted after everyone is given 2 weeks to check out and discuss what is posted!
69 year old man
with substernal chest discomfort.
BP 70 mm Hg. History of HTN.
Vent. rate 64 bpm
|QSR duration 80 ms|
PR interval 138 ms
|QT/QTc 394/406 ms|
P-R-T axes 59 55 84
Questions for Thoughts
- In what part of the heart is there a problem?
- What is the differential for the ST-segment abnormalilty seen in V1 and V2?