Pulmonary Embolism (ECG -changes )
Pulmonary Embolism (ECG -changes )
Download
ECG of the same patient,recorded during  sudden episodes of dyspnea , retrosternal discomfort.   ECG Description: * Sinus rhythm,  (respiratory arrhythmia), with a Heart Rate of 75-100 bpm (average - 80 .bpm ) * Electrical axis of heart deviated toward  the right (the maximum amount of QRS in lead III). *Symptoms of hypertrophy or overload of  Left Atrium . *Double humped  P- wave in lead II (P-mitrale), the distance between the "top - 40 ms; (In V1 having a second negative phase depth -0,1 mV.) *Symptoms of hypertrophy or overload PP (P-pulmonale in lead II - P amplitude greater than 2.5 mm). *Symptoms of RV hypertrophy and  overload: [Dominant R in V1-V2 (the ratio of R / S at V2-V1> 1)] [Signs of RV overload (kosoniskhodyaschy ST and negative T in V1-V4) *McGinn for signs of Wight (McGinn-White sign, symptom SI- QIII-TIII) - the appearance of S wave in 1st lead  , Q waves, and T in lead III.]  *Axis deviation to the right (in the previous ECG. Electrical axis of the heart was  normal), * increased signs of hypertrophy (in this case - an overload) of the right atrium and ventricle,  *The appearance of signs McGinn-White, together with the characteristic clinical picture, indicating a high risk of pulmonary embolism for a given patient .  * Further tactics - Urgent CT-scan of  pulmonary artery with contrast to confirm the diagnosis.
Anterior widespread Q-myocardial infarction. P-pulmonale
Anterior widespread Q-myocardial infarction. P-pulmonale
Download
ECG of a  patient .77 years old who was hospitalized in serious condition with suspected acute myocardial infarction. ECG  Description : *Sinus rhythm, heart rate of 135 beats / min, sinus tachycardia *Electrical axis of heart - deviated verticaly  * Changing the type of complex atrial P-pulmonale (hypertrophy or dilatation of the right atrium) *Q-myocardial infarction front propagation (pathologic Q wave and ST-segment elevation in V1-V6)
Situs inversus viscerum - standard electrode placement
Situs inversus viscerum - standard electrode placement
Download
ECG of a patient with dextrocardia with elecrodes placed in a standard way. Characteristics: Electrical axis is vertical or deviated to the right Positive waves in aVR (positive P, QRS, T) Negative waves in lead I (negative P, QRS, T) Absence of R wave progression in the chest leads.
RAH wiht  the deviation electrical axis of heart to right
RAH wiht the deviation electrical axis of heart to right
Download
ECG Description:   *SInus Rhythm: , .Heart rate: 100 beats / min (sinus tachycardia); RQ- to 0.16, QRS- 0,08 with, QT- 0,29 seconds;  * Electrical axis of heart  having sharp deviation to the right (angle α +1500). *Symptoms of hypertrophy of the right atrium -in leads II, III, aVF P wave with high amplitude pointed apex (P-pulmonale) *Heart rotation around the longitudinal axis in a clockwise direction (displacement in the transition zone V4) * violation of intraventricular conduction (Rsr in leads III, aVF)
Chronic left ventricular aneurysm
Chronic left ventricular aneurysm
Download
ECG  of 70 years old patient, suffered from acute myocardial infarction 2 months ago. Complaints about general malaise, shortness of breath on minimal exertion, swelling of the lower extremities.   - Sinus rhythm, right heart rate 71 beats / min. - Electrical exis of the heart - deviated to right - Widespread scarring of the anterior and lateral walls of the left ventricle.  - Segment elevation ST. - Markers of myocardial necrosis negative (CK-MB, troponins)   - It was suspected chronic left ventricular aneurysm, which is characterized by the same changes on the ECG, as in the acute phase of myocardial infarction. The only difference - the lack of dynamics of the segment ST. Aneurysm anteroseptal area of the left ventricle was confirmed on echocardiography
Left posterior fascicular block + RBBB, unstable angina
Left posterior fascicular block + RBBB, unstable angina
Download
ECG of a 82-years-old patient, delivered by an ambulance with an intensive oppressive heart pain.   ECG description: Regular sinus rhythm, 77 bpm. Right axis deviation ( α>+90°). Right bundle branch block (RBBB) (QRS complex > 0,12 sec., rSr' pattern in V1, wide S in V5-V6). Left posterior fascicular block (is indicated by pronounced right axis deviation, not typical for RBBB). Signs of impaired blood flow in the anterior-septal area of the left ventricle (ST elevation up to 0,15 mV in V1-V3, negative T in V1-V4). Make also a point of broad two-peak P wave (probable pathology of the left atrium) and almost boundary duration of PQ-interval (0,18 sec)   Left posterior fascicular block is often associated with complete RBBB, as in this patient. Also there are often disturbances of AV-conductivity in conjunction with such pathology. Although it's not been seen in this ECG, the patient has it as well: he has been implanted earlier a pacemaker working on-demand in case of decrease in heart rate below 60 bpm because of episodes of complete heart block.  
Спортивное сердце. Появление потенциально патологических изменений.
Спортивное сердце. Появление потенциально патологических изменений.
Download
ЭКГ 35 летнего спортсмена, снято в спортивном диспансере перед соревнованиями. Описание ЭКГ: Ритм синусовый, дыхательная аритмия, 64 удара в минуту Отклонение ЭОС вправо (максимальная положительная сумма QRS - в III и aVF). Бифасцикулярная блокада (БПНПГ + блокада задней ветви ЛНПГ) Расширение QRS до 0,12 сек; Раздвоение комплекса QRS в V1, характерное для БПНПГ (второй зубец - спрятан на нисходящем колене волны S); Расширение волны S в V6, характерное для БПНПГ. Увеличение времени внутреннего отклонения более 40 мсек; Отклонение ЭОС вправо без других признаков гипертрофии ПЖ; Комплексы qR в II, III, aVF   Не смотря на то, что в понятие "спортивное сердце" (подробнее...) входит неполная БПНПГ, наличие блокады ЛНПГ или ее ветвей указывает на возможные патологические изменения миокарда, например, из-за слишком высоких нагрузок.Такой спортсмен не может участвовать в соревнованиях до прохождения полного обследования (Эхо-КС, Стресс-Эхо или ВЭМ, Холтер-мониторирование, перфузионные исследования миокарда).      
 
 
Powered by Phoca Gallery