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Sinus tachycardia

Left Bundle Branch Block

Tue, 01/17/2017 - 18:36 -- Dawn

This ECG was taken from an unknown patient.  It shows sinus tachycardia with left bundle branch block. The ECG criteria for left bundle branch block are: 

* Wide QRS (.12 seconds or greater)

* Negative QRS deflection in V1

* Positive QRS in Leads I and V6 

* Supraventricular rhythm

Teaching Series - Tachycardia and Left Anterior Fascicular Block

Sat, 10/15/2016 - 15:48 -- Dawn

This series of three ECGs is from a 60-year-old man who was brought to the Emergency Department after being involved in a motor vehicle accident.  No injuries were found, but the patient was severely intoxicated by alcohol consumption.  He was conscious but agitated. 

ECG NO. 1     15:07:23

ECG Basics: Sinus Tachycardia vs. PSVT

Thu, 04/21/2016 - 00:13 -- Dawn

Narrow-complex tachycardias can be very confusing to students of basic-level ECG.  There are very many rhythms that fall into the broad category of narrow-complex tachycardia.  We usually further divide them into sinus tachycardia and other "supraventricular tachycardias".  The basic student will want to make this distinction, as well as be able to differentiate atrial fib and atrial flutter from the other SVTs.  The more advanced student will want to go into more detail about which mechanism for supraventricular tachycardia is present.

ECG Basics: Sinus Tachycardia, Peaked T Waves, and Baseline Artifact

Sun, 03/13/2016 - 21:45 -- Dawn

This strip offers several good teaching opportunities.  If it were a 12-lead ECG, no doubt it would be a bonanza!  First, there is sinus tachycardia at a rate of about 138 per minute.  The P waves are all alike and regular.  The T waves are tall and narrow, with a sharp peak.  This is often a transient sign of hyperkalemia, and should be investigated with serum electrolyte tests and with a 12-lead ECG.  In addition, the baseline shows a wandering type of artifact.

Inverted T waves in Lateral Wall

Tue, 11/10/2015 - 20:45 -- Dawn

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.

ECG Basics: Sinus Tachycardia

Wed, 06/10/2015 - 20:53 -- Dawn

This is a good teaching strip on many levels.  At the BASIC level, we see a strip that clearly meets all the criteria for sinus tachycardia:  a regular rhythm over 100/min. with P waves that look normal and all look alike.  The rate is 110 per minute.  The PR interval is just at the upper limits of normal at .20 second, or 200 ms.  The QRS complex is within normal limits, but slightly wide at .10 seconds.

Sinus Tachycardia in a Child

Wed, 07/17/2013 - 23:02 -- Dawn

A six-year-old girl was found with her two younger siblings and her mother, unconscious, in a room filled with carbon monoxide.  The mother had been using a charcoal grill inside the house.  She managed to call 911 before losing consciousness, and the fire rescue paramedics broke into their house, saving them.  This six-year-old required treatment in the pediatric intensive care unit, but recovered completely.  The lesson for our students is to judge rate in the setting in which it is found.  The heart rate here is 136/min.

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Jason's Blog: ECG Challenge of the Week for March 24th - 31st.

Patient's clinical data:  47-year-old black man.  Another serial ECG (seen below) showed a supraventricular tachycardia (SVT) at a rate of 164/min that was diagnosed by an Electrophysiologist as atrioventricular nodal reentrant tachycardia (AVNRT).  How does knowing the mechanism of AVNRT help you in determining the nature of the mechanism in this week's ECG.  

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Jason's Blog: ECG Challenge of the Week for Feb. 24th - March 3rd.

Patient's clinical data:  55-year-old white man admitted to the surgical intensive care unit (SICU). 

Part of the computer's interpretation was:
Sinus tachycardia 1st degree AV block Occasional
Premature supraventricular complexes

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