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ECG Abnormalities_Part 15

Sunday, November 21, 2010

A 58 year old male with a history of  DM, hypertension, and dyslipidemia presents with substernal chest pressure for 30 minutes. The pain began at rest,severe in nature, was mild to begin with then increased in intensity, is worse with exertion, radiates to his left arm, is not pleuritic or positional, and is associated with diaphoresis, shortness of breath, and nausea.
His temperature is 37.2, blood pressure 90/50mmhg, heart rate 100/bpm, respiratory rate is 16/min. No jugular venous distension is present, he is tachycardic and an S4 heart sound is present. No murmurs are heard. His lungs are clear to auscultation. The rest of his exam is normal.

What is the diagnosis?


The ECG findings include:

1) Normal sinus rhythm
2) Poor R wave progression (possibly indicated an anterior wall infarct - age undetermined)
3) Old inferior wall infarct (indicated by Q waves in inferior leads)
4) Biphasic T waves in leads V1 - V4 possibly consistent with ischemia


22 Responses to ECG Abnormalities_Part 15

  1. Anonymous Says:
  2. MI

  3. Anonymous Says:
  4. and the anterior inferior ventricular wall?

  5. inferior wall MI and Anterio septal Ischemia..+

  6. Anonymous Says:
  7. old IM of posterior wall and acut coronary syndrom of septal wall!

  8. Anonymous Says:
  9. anterior mı + anteroseptal iskemi

  10. Anonymous Says:
  11. ant wall infraction

  12. Anonymous Says:
  13. angina pectoris

  14. Anonymous Says:
  15. Inferior changes has q waves 3and avf. , ischemic changes due to htn t waves inversions in v3--v6..s4. Heartsound l sided failure

  16. Anonymous Says:
  17. anterolateral acute MI,,,,with pathological Q wave at lead V1

  18. Bhavi shah Says:
  19. Old ant wall MI with ischemic changes ..

  20. Anonymous Says:
  21. inferior MI

  22. Anonymous Says:
  23. inferior wall mI

  24. Anonymous Says:
  25. acute anterior wall MI

  26. Anonymous Says:
  27. acute post-lateral MI

  28. Hai NGUYEN Says:
  29. Anterior ischemia (Q-nonspecific in V1, negative T in all precordia) with old inferior MI (Q wave in DIII and aVF).

  30. Anonymous Says:
  31. Acute Q-wave MI anteroseptal; old inferior Q wave MI

  32. Anonymous Says:
  33. Proximal LAD occlusion. Mild ST elevation in Anteroseptal leads with a biphasic TW in V1 - V4, TW inversion in V5 and V6 with ST depression in Lead I.


  34. Anonymous Says:
  35. acs (nstemi)

  36. Anonymous Says:
  37. Q waves in III and avF : Inferiou MI , T wave inversion V4 V5 ...when is the answer??

  38. Anonymous Says:
  39. Embolia pulmonum.....s1Q3T3

  40. Anonymous Says:
  41. S1/Q3/T3?....No. The S1 indicates a right axis deviation of the cardiac vector. The S-wave shown in this 12-lead ECG is very small. The patient's axis is normal, so a PE is not suspected. I would like to know what the pt's SpO2 is. According to the data above, I'm assuming that is is within normal limits since nothing was mentioned...."The rest of his exam is normal". The key features to this case is the pt's symptoms are classic for an MI (began at rest, worsens with exertion, radiates to left arm, diaphoretic, nausea, and SOB). The S-4 is associated with papillary muscle involvement to the LV. The papillary muscles are supplied by the LAD and LCX (anterior), and by the PDA (posterior). This would indicate a proximal LAD or LCX occlusion, given the S/S and ekg.

  42. Anonymous Says:
  43. MI


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