This ECG is from a 54-year-old woman who had an M.I. one week prior to this tracing. She did not receive interventional treatment, as it was not available where she lived when this happened years ago. Her ECG shows the signs of healing injury, as well as probable permanent damage.
Pathological Q waves
This ECG was obtained from a 49-year-old man who was a patient in an Emergency Dept. We do not know his presenting complaint, only that he had a history of insulin-dependent diabetes mellitus (IDDM). It was noted by the donor of the ECG that the patient had no chest pain, no shortness of breath, and no other cardiac symptoms. We do not know his hydration or electrolyte status. There are quite a few interesting abnormalities on this ECG, and the exact interpretation would, of course, depend upon the patient's clinical status.
This 88-year-old woman was brought to the Emergency Department in cardiogenic shock. Very little is known of her past medical history, but it was relayed to the EMS responders that she had been ill for about four days, when she became much worse.
This week's ECG is from a 47-year-old man who experienced a sudden onset of chest pain while mowing his lawn. He went on to suffer a cardiac arrest and was resuscitated. We do not have long-term followup on his outcome.
If you are teaching frontal plane axis to your students, you will need to teach them HOW to determine the axis - usually beginning with the QRS axis and then adding the P and T waves. But, you also need to teach them WHY we measure axis, to provide relevance to something that may seem challenging to beginners. There are many ECG interpretations that rely heavily or are dependent upon the determination of the axis.
This is an ECG from a 95 year old man who was recovering from an anterior-septal wall M.I. Other clinical data for this patient has been lost, except that he suffered a new right bundle branch block during this M.I. The ECG shows pathological Q waves in V1, V2, and V3, consistent with permanent damage (necrosis) in the anterior septal wall. The ST segments in those leads are coved upward. Even though the J points are not elevated, this ST segment shape suggests recent injury.
During our summer break, we are reprising a few of the best ECGs from our archives, to give you a chance to comment or to ask questions.
This ECG was taken from a 52 year old man who was complaining of chest pain, with a history of severe multi-vessel disease. He has a history of M.I. and states he has five coronary stents.
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