ECGs by diagnosis: Difference between revisions

(Created page with "==Arrythmias== See Cards: Arrythmias (DDX) ==MI== -T wave usu tracks w/ the QRS, thus if QRS primarily negative, twi is not necessarily abnl (nl twi in V1). -ST elevatio...")
 
m (Danbot moved page ECGs by Diagnosis to ECGs by diagnosis without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase)
 
(30 intermediate revisions by 7 users not shown)
Line 1: Line 1:
==Arrythmias==
==ACS==
''See [[ACS]]''


 
==Aneurysm==
See Cards: Arrythmias (DDX)
''see [[Left ventricular aneurysm]]''
 
*Suggested by:
**ST elevation >4wk
 
**QS wave in setting of ST-segment elevation with out T-wave inversion
==MI==
 
 
-T wave usu tracks w/ the QRS, thus if QRS primarily negative, twi is not necessarily abnl (nl twi in V1).
 
-ST elevation non-specific, also w/ LVH & strain, LBBB, CA spasm, pericarditis, "early repol", hyperK, dig/TCA's, CVA, Vent. aneurysm, hypothermia.
 
-Non-transmural: ST dep at least 1.0mm, twi.
 
-II, II, AVF for inf. MI
 
-V1-3 for anteroseptal inf.
 
-I, AVL, V4-6 for lat. wall inf.
 
-V1 or V2-6 anterolat.
 
-Large R and ST depression in V1-V2= POST. INFARCT! Post MI usu seen w/ inf MI b/c RCA supplies both in 90% of pts!
 
-Pts w/ inf. infarction +/or post wall mi often also have RV mi, need R sided leads!!
 
-STE >/= 1mm in V3R or V4R suggest RV MI!
 
-STE > 2wks= poss vent aneurysm!
 
-STE in avR and avL = LMA stenosis
 
-STE in avR and V1 = LAD or LMA stenosis
 
-if STE > 1.5 mm in avR pt has 75% mortality from AMI  --> activate cath lab (unless pt is in SVT, then STE is allowed)
 
 
Infarct notes:
 
-inf wall: recip. In 1 and AVl. Downward sloping ST in AVl is often first sign.
 
-Any ST depression in V1 to V3 in a LBBB is pathological and suggestive of a post. Wall MI.
 
-Poor r waves progression-no r's by V4
 
-persistent t-wave elevation 6 wks post mi-vent. Anyeursm.anteroseptal with biphasic/inverted t wave.
 


==Pericarditis==
==Pericarditis==
''See [[Pericarditis*[[ECG]]|Pericarditis]]''


 
==Electrolyte Disorders==
-Stage I: ST elevated in precordial leads, esp. V5-6 & I-II. Isoelectric or depressed ST in V1. PR depression in II, AVF, V4-6.
*[[Hyperkalemia]]
 
*[[Hypokalemia]]
-Stage II: ST returning to baseline. T wave amplitude decreases.
*[[Hypercalcemia]]
 
*[[Hypocalcemia]]
-Stage III: ST isoelectric. TWI where prior STE.
 
-Stage IV: Resolution of T wave changes.
 
-Also ST:T ratio >0.25 in V6
 
(Depressed PR, Diffuse ST elevation, Scooping upwardly concave ST segments, Notching at the end of the QRS)
 
 
==HyperK==
 
 
-5.5-6.6 -> tall peaked T, deep S in I and V6, QRS nml
 
-7.0-8.0 -> QRS widens, slurred initial and term QRS, ST elevation, low wide P's, AV blocks, SA arrest, bradycardia.
 
->8.0 -> widened QRS, Vfib, asystole.
 
 
==HypoK==
 
 
-3.0-3.5 no change or flat T' sand U's in V2-3, QT interval and QRS nml.
 
-2.7-3.0 U taller, T smaller, esp. V2-3
 
-<2.6 ECG change includes tall U's, QT and QRS wnl.
 
 
==HyperCa==
 
 
-Increased QRS duration (slight)
 
-ST short or absent
 
-Short corrected QT.
 
-PR long
 
 
==HypoCa==
 
 
-slight decrease in QRS.
 
-ST and corrected QT long
 
-PR short.
 
-T's flat to inverted.
 


==CNS==
==CNS==
 
*[[SAH]], [[IC Bleed]], [[CVA]]
 
**Diffuse wide, deep, blunted, inverted T waves
-SAH, IC bleed, stroke, can see diffuse wide deep, blunted inverted T's. and QT prolonged
**[[QT Prolongation]]
 


==Pacemakers==
==Pacemakers==
''see [[Pacemaker complication]]''
*Should be in the apex of right ventricle
*[[ECG]] should mimic LBBB with LAD


==Pulmonary Embolism==
''see [[Pulmonary embolism]]''
*Sinus [[tachycardia]]
*S1Q3T3 (Sp, not Sn)
*Right axis deviation
*RBBB
*T wave inversions leads V1-V3


-Should be in the apex of R vent.
==[[Hypothermia]]==
 
[[File:Osborn wave.gif|thumb]]
-ECG should mimic LBBB, w/ L axis.
*Osborn wave (J wave) - Positive deflection at the J point
 
**Height of the J wave correlates to the degree of hypothermia<ref>Vassallo SU, Delaney KA, Hoffman RS, et al. A prospective evaluation of the electrocardiographic manifestations of hypothermia. Acad Emerg Med. 1999; 6(11):1121-1126.</ref>
*Bradyarrhythmias, AV blocks
 
*Prolonged PR, QRS, QT intervals
==PE==
*Shivering artifact
 
 
-S1Q3T3
 
(good specificity, poor sensitiviy)
 
 
==Source==
 
 
DONALDSON 17/09 (Adapted from Niemann/Lampe)
 


==See Also==
*[[ECG (Main)]]
*[[STEMI equivalents]]


==References==
<references/>


[[Category:Cards]]
[[Category:Cardiology]]

Latest revision as of 05:31, 22 March 2026

ACS

See ACS

Aneurysm

see Left ventricular aneurysm

  • Suggested by:
    • ST elevation >4wk
    • QS wave in setting of ST-segment elevation with out T-wave inversion

Pericarditis

See [[Pericarditis*ECG|Pericarditis]]

Electrolyte Disorders

CNS

Pacemakers

see Pacemaker complication

  • Should be in the apex of right ventricle
  • ECG should mimic LBBB with LAD

Pulmonary Embolism

see Pulmonary embolism

  • Sinus tachycardia
  • S1Q3T3 (Sp, not Sn)
  • Right axis deviation
  • RBBB
  • T wave inversions leads V1-V3

Hypothermia

Osborn wave.gif
  • Osborn wave (J wave) - Positive deflection at the J point
    • Height of the J wave correlates to the degree of hypothermia[1]
  • Bradyarrhythmias, AV blocks
  • Prolonged PR, QRS, QT intervals
  • Shivering artifact

See Also

References

  1. ↑ Vassallo SU, Delaney KA, Hoffman RS, et al. A prospective evaluation of the electrocardiographic manifestations of hypothermia. Acad Emerg Med. 1999; 6(11):1121-1126.
Retrieved from "https://www.wikem.org/w/index.php?title=ECGs_by_diagnosis&oldid=388480"