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 #116    [ Scroll down to submit answer ]
You are a member of the medical team caring for the firefighters of the recent California wild fires. The 60-year old pilot below presents with chest pain. Your interpretation/advice is... choose only one...
Tracing of the Week (Tracing #116)
A..... QT interval prolongation. QTc is calculated from Bazett's Equation = 380 msec. This places the patient at risk for Ventricular Tachycardia (Torsades de Pointes) and syncope.
B..... Normal tracing. She should be cleared for flying.
C..... Diffuse T-wave flattening suggestive of hypokalemia. Before clearance for flying, you should insist that her serum potassium be checked.
D..... Minimal ST elevation (concave down/coving) in Leads II, III, avF, V5, V6 suggestive of an acute ST elevation MI (inferolateral).
E..... Minimal ST elevation in Leads II, III, avF, V5, V6 concave down (coving), most likely a benign normal variant (early repolarization). She is cleared for flying.
F..... Minimal ST depression and biphasic T-wave in Lead avL noted. This is a normal variant. She is cleared for flying.
G..... Minimal ST depression and biphasic T-wave in Lead avL noted. This is consistent with ST-T changes of reciprocity.
H..... D and F only.
I..... D and G only.This combination (& if clinically indicated), is virtually diagnostic(in absence of LBBB and LVH) of the STEMI. She should be immediately transported to the nearest hospital along with Rx including ASA, NTG+++++ if available.
J..... Wolff-Parkinson-White syndrome (WPW). Hint: magnify Lead V6 and note the Delta wave. She is cleared for flying.
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