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 #4    [ Scroll down to submit answer ]
You are working as a paramedic at a ski resort in Snowshoe, WV, USA. An 82 year old male walks into your base clinic with complaints of chest tightness. He is cold, clammy, diaphoretic. Your ECG interpretation and/or treatment would be...(Choose only ONE)
Tracing of the Week (Tracing #4)
A.....LBBB with secondary T-wave changes. The analysis as discussed below in B, C, D, E and F are all booby-traps, since the observed changes are most certainly secondary to the LBBB pattern and are in fact pseudo.
B.....LVH with ST-T changes (strain).
C.....The ST elevations, peaked T's and significant Q-waves in Leads V1 and V2 most certainly represent an acute septal MI (ST elevation). The peaked T-waves represent hyperacute T's and suggest that the MI is early (first few hours).
D.....There are peaked T-waves, significant Q-waves and ST elevation in Leads V1 and V2 that are probably secondary to the LVH pattern i.e. they are probably pseudoinfarction/ischemia changes. However, I cannot rule-out an acute septal MI (STEMI).
E.....The ST depression in Leads I, II, aVF, V6 and V5 most certainly represents acute ischemia or acute infarction (non-STelevation).
F.....The ST depressions and T-wave inversions in Leads I, II, aVF, V6 and V5 are most likely secondary to the LVH pattern (strain)
G.....The rhythm is second degree AV block (Wenckebach). HINT: use a magnifier to carefully look at the entire length of the rhythm strip Lead II and Lead I).
H.....B, D and F only.
I......B, D, F and G only
J.....B, C, E, and G only
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