Presentacin de PowerPoint

1. Normal sinus rhythm2. 3rd degree AV block3. Right bundle branch block4. Right axis deviation

1. Atrial fibrillation2. Atrial flutter with variable conduction3. Multifocal atrial tachycardia (MAT).

A posterior wall MI frequently occurs along with an inferior wall MI due to the shared blood supply from the right coronary artery. The posterior wall demonstrates ECG changes the opposite of other myocardial segments due to the location, thus instead of ST segment elevation, a posterior myocardial infarction is characterized by ST depression in lead V1 and frequently V2. The R wave is large in lead V1. Turn the ECG upside down and you will see ST segment elevation in V1 and a large Q wave which are normal findings of a myocardial infarction. For a detalied review, click the Posterior MI ECG Review button below.Note that the causes of a R wave being larger than the S wave in lead V1 include a posterior myocardial infarction, right bundle branch block, WPW Type A, right ventricular hypertrophy, ventricular tachycardia with a right bundle branch block pattern and isolated posterior wall hypertrophy (can occur with Duchenne's muscular dystrophy).1. Normal sinus rhythm2. Inferior ST elevation myocardial infarction3. Posterior myocardial infarction4. Left atrial enlargement

1. Atrial tachycardiaNote that the P wave is not upright in lead II (indicating that it originates at a site other than the sinus node, a.k.a. "ectopic"). Each P wave is followed by a QRS complex which is narrow (supraventricular in origin). Click below for a detalied review of ECG findings in ectopic atrial rhythms.

1. Sinus tachycardia2. Acute anterior myocardial infarctionThis ECG demonstrates an "extensive anterior" and "tombstoning" of the ST segment seen during a large acute anterior myocardial infarction. This is usually the result of thrombosis of the left anterior descending coronary artery. In this ECG, the thrombosis would be proximal in the left anterior descending since the septal leads (V1 and V2) are involved. Also, note the inferior changes. Some left anterior descending coronary arteries "wrap around" the cariac apex and can supply part of the inferior wall as well which was indeed the case in this situation. For a complete, detalied review of the ECG changes during an anterior myocardial infarction, click the Anterior MI ECG Review button below.

1. Atrial flutter with a slow ventricular response - clockwise rotationThis ECG has typical atrial flutter waves in a "sawtooth" pattern rotating in a clockwise direction. For a complete review of atrial flutter including determining rotation direction, typical versus atypical and multiple images/examples, click the atrial flutter review link below.

Normalyolo

1. Sinus tachycardia2. Left ventricular hypertrophy

1. Normal sinus rhythm2. Second degree type I AV block3. Right bundle branch block4. Left anterior fascicular block5. Left atrial enlargement - P-mitrale pattern

1. Normal sinus rhythm2. Pericarditis

1. Sinus tachycardia2. Anterior myocardial infarction3. Hyperacute T wave abnormalityMany different T wave abnormalities exist. Hyperacute T waves are the very first sign of a myocardial infarction, however are frequently missed on the ECG since they are only transient during the first few minutes of the infarction. Hyperacute T waves tend to be a bit more symmetric and broad at the top than those "peaked" T waves seen in hyperkalemia, although this is difficult to distinguish at times. On this ECG, the ST elevation gives away the fact that the T waves are hyperacute. Some different T wave abnormalities are pictorally shown below: