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150 Practice ECGs: Interpretation and Review - Part 10

Có xuất hiện được các sóng R nhỏ dẫn precordial. Sự mất mát của R trong V5 có lẽ là từ vị trí dẫn đầu. Bạn mong chờ V5 có một sự xuất hiện một nơi nào đó giữa của V4 và V6. Nó có thể là các điện cực cho V5 đã được đặt một sắp xa ra quá thấp trên tường ngực | 240 150 Practice ECGs Interpretation and Review 90. Interpretation NSR 90 min. PR .14 QRS .09 QT normal. Axis 20 . Abnormal due to PRWP and small inferior Qs. Comment I am not sure about the diagnosis of anterior MI. There appear to be small R waves in the precordial leads. The loss of R in V5 is probably from lead position. You would expect V5 to have an appearance somewhere between that of V4 and V6. It could be that the electrode for V5 was placed an interspace too low on the chest wall. A repeat ECG or a previous tracing might show a larger R in V5 confirming PRWP rather than anterior MI. I have not included many comparisons with previous ECGs in this exercise because of space. Comparison with previous ECGs should always be a part of the ECG report. 91. Interpretation NSR 60 min. PR .18 QRS .16 QT normal. Axis -60 . Abnormal due to RBBB LAFB and anterior MI of uncertain age. Comment The small initial R wave in inferior leads makes LAFB more likely than inferior MI. This is another example of our ability to diagnose MI in the presence of RBBB. There is distortion of P waves in precordial leads an artifact. 92. Interpretation NSR 90 min. PR .14 QRS .08 QT normal. Axis 15 . Abnormal due to nSsT-TCs. Comment I see a bit of ST elevation in V2. I doubt that it means anything and I would not have called this an abnormal ECG if that was the only finding. In this case there are T wave changes in inferolateral leads. As they are nondiagnostic they are nonspecific. 93. Interpretation ST 120 min. PR .16 QRS .09 QT normal. Axis 60 . No obvious abnormality but there is marked baseline artifact consider repeat ECG. Comment What a mess Some would discard it as unreadable. But the ECG may have been done at an important time in this patient s life perhaps during chest pain. If you look carefully you can make a number of observations note my measurements . I am also confident that there are no Qs or major ST-T changes. This may be electrical artifact a technical problem with the