View the
Arrhythmia Recognition Webcast Series
|
 |
Practice ECG 8
Here we see a P wave that meets P-pulmonale criteria in II, and also qualifies for LAE because of the morphology in V1. Note that there is no rhythm strip with this ECG. As you can see, this makes interpretation more difficult.
How wide is the QRS complex? Well, it is more than 0.12 seconds. So what are the three possible blocks that this could be? RBBB, LBBB, or IVCD. There is a slurred S wave in lead I and a qR' wave in V1, suggestive of an RBBB. Why is there no slurred S in V6? Well if you notice, V2 to V6 are almost identical; this makes us think that the technician who performed the test had some serious lead placement problems. Remember, leads I and V6 should be identical.
The qR' complex develops in patients who have an RBBB and an old anteroseptal MI; hence, the Q wave. Think of it as a pair of rabbit ears with the right ear dead because of a bunny stroke!
« Back to All
|