12 Lead ECG Interpretation Course by Dr. Vernon Stanley Course Overview
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FREE 12-Lead ECG Interpretation Tracing of the Week
Tracing #221    [ Scroll down to submit answer ]
You have recently been selected to interpret ECGs for your clinic. The patient below presents with complaints of shortness of breath and weakness. The frontal plane electrical axis is calculated as - 48 degrees.....Your interpretation is......
Tracing of the Week (Tracing #221)
A.....A normal octogenarian variant
B..... Voltage criteria of LVH with ST-T changes (strain).
C..... LAFB
D..... Atrial Fibrillatiion with rapid ventricular response
E..... All the above
F..... B,C and D only. The ST-T changes are most likely due to LVH but you should compare with the old tracing and clinical correlation recommended to exclude ischemia/infarction.
G..... B and D only. The ST-T changes are most likely due to LVH but you should compare with the old tracing and recommend clinical correlation to exclude ischemia/infarction.
PEARL---Remember that the LAFB pattern will often cause a high voltage R-wave in Lead avL. This high voltage may or may not represent LVH(pseudo LVH), but if ST-T changes are present as in this tracing, it IS more likely to represent LVH.
........
Note: For other examples see pages 27, 30, 57, 87, 108, 109, 115, 127, 130 and 218 of Dr. Stanley's Tracing Manual.
© 2014 Vernon R. Stanley, M.D., Ph.D. All rights reserved.