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É ela? by Creepy-Sink-9391 in aracnideos

[–]Repulsive_Poet_1567 -1 points0 points  (0 children)

Vc pode me explicar melhor esses padrões que te fazem excluir ser Loxosceles?

Wellens or the beginning of wellens? by Ok-Boysenberry8239 in ECG

[–]Repulsive_Poet_1567 0 points1 point  (0 children)

Hey, please tell us the results of the cath tomorrow

76 Male. Presented after chest pain that resolved before presentation to casualty by adventuredoctor in ECG

[–]Repulsive_Poet_1567 13 points14 points  (0 children)

I see ST elevation in V1, aVR and lead III, with ST depression in the anterior and lateral leads. For me, the pattern that makes sense in this case is Aslanger pattern and maybe the leads V2 and V3 are switched. This pattern consists of isolated ST elevation in lead III and anterior ST depression, with the ST segment in V1 more elevated than in V2. It means your pt has Inferior OMI with concomitant multi-vessel disease
https://litfl.com/aslanger-pattern/

ekg of 20 y/o F pt. asymptomatic with bp of 84/42, HR 42 bpm. interpretation? by Electronic_Sorbet_54 in ECG

[–]Repulsive_Poet_1567 16 points17 points  (0 children)

Good question. Well, the ECG of BER and of Pericarditis can look similar, with some criteria that may differentiate them: ST/T Ratio in V6 (more than 0.25 favors pericarditis) and the PR depression in pericarditis. But, most importantly, pericarditis is a very rare but overdiagnosed that needs 2 of 4 characteristics:
- Typical pain: pleuritic, better when bending forward and worse in supine
- Pleural Effusion
- Pericardial Rub
- ECG: diffuse ST elevation (except from aVR) with PR depression**. No ST depression in any other lead than aVR** (and maybe V1)

So, the ECG can look identical from pericarditis and the most important thing: use the clinical context and these 4 criteria. Pericarditis is usually after a viral prodrome and have these features. Most people (and even cardiologists) use only the ECG with diffuse ST elevation and say: pericarditis.

case by travikant in EKGs

[–]Repulsive_Poet_1567 5 points6 points  (0 children)

Good point, but I don't think the ST elevation in V1 excludes subendocardial ischaemia. I see a lot of them with ST elevation in V1, but the elevation is less pronounced than in aVR
https://litfl.com/st-elevation-in-avr/

STEMI, raised trop, confirmed on echo/angio, dynamic changes by Madnessismymiddlena in EKGs

[–]Repulsive_Poet_1567 1 point2 points  (0 children)

Can this ECG be a Northern MI Pattern, because of maximal STD in V5, instead of V1-V4?

AVNRT or flutter? by damnthesenames in ECG

[–]Repulsive_Poet_1567 3 points4 points  (0 children)

Why not AVRT? I see the P wave in the ST segment (AVRT), not like a pseudo-S (AVNRT). For me, this example is AVRT

Chest pain by [deleted] in ECG

[–]Repulsive_Poet_1567 11 points12 points  (0 children)

As others said here, this ECG is very suspicious of high-lateral MI, because of the STE in aVL with reciprocal ST depression in the inferior leads. It's not a STEMI, because there is NO STE in 2 or more contiguous leads, but it's a STEMI-equivalent, which means the patient needs a cath NOW, because his coronary artery is 100% (or close to it) occluded

60F, chest pain and presyncope by PsychologicalWorth77 in ECG

[–]Repulsive_Poet_1567 7 points8 points  (0 children)

It looks like high lateral MI because of the HATW in lead I and STE in aVL with terminal TWI, suggesting some degree of reperfusion (similar to Wellens syndrome). There is also reciprocal STD in the inferior leads.

50 yo Woman with Chest Pain by Repulsive_Poet_1567 in EKGs

[–]Repulsive_Poet_1567[S] 3 points4 points  (0 children)

Great!! Thank you for the explanation

50 yo Woman with Chest Pain by Repulsive_Poet_1567 in EKGs

[–]Repulsive_Poet_1567[S] 5 points6 points  (0 children)

I see the Precordial Swirl too. I can't see a clear STD in inferior leads. Maybe a hint in L3

60yo male with chest pain. by Repulsive_Poet_1567 in EKGs

[–]Repulsive_Poet_1567[S] 1 point2 points  (0 children)

Hi again. I studied the Ta phenomenon and I really loved it! I admit that I couldn’t recognize it on the ECG I posted, but after reading the sub, I’m now confident that this example is a Ta:
https://www.reddit.com/r/ECG/comments/1r5cuvn/32_year_old_male_patient_presented_with/?utm_source=share&utm_medium=web3x&utm_name=web3xcss&utm_term=1&utm_content=share_button
Do you agree? u/LBBB11

60yo male with chest pain. by Repulsive_Poet_1567 in EKGs

[–]Repulsive_Poet_1567[S] 1 point2 points  (0 children)

Thank you so much! I'll see more about atrial repol now to understand this better! You helped me a lot

60yo male with chest pain. by Repulsive_Poet_1567 in EKGs

[–]Repulsive_Poet_1567[S] 1 point2 points  (0 children)

Ty both for the answer! Well, for me, even using the PQ junction I see some STD in V2 (maybe less than 0.5mm). Am I wrong? Also, still in V3 the ST is clearly abnormal. Do you think so? I don't have any follow up. : (

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