Ken Grauer, MD

SEPTEMBER 22, 2023

KEY Point: Although true that patients with longstanding, severe pulmonary disease may manifest a QRST complex in standard lead I with marked overall reduction in QRST amplitude ( See ECG Blog #65 — regarding Schamroth’s Sign ) — you should never normally see a completely flat line in any of the standard limb leads.

Blog 178

Blog Chest Pain Bradycardia Physiology 178

Dr. Smith's ECG Blog

FEBRUARY 12, 2023

This suggests that there is pulmonary hypertension and thus possibly RVH. The estimated pulmonary artery systolic pressure is 31 mmHg + RA pressure. In a patient with RVH — the finding of a qR pattern has been closely correlated with pulmonary hypertension. Right atrial enlargement, severe. Severe tricuspid regurgitation. --The

Pulmonary 40

Pulmonary Chest Pain Hypertension Tricuspid 40

Dr. Smith's ECG Blog

FEBRUARY 28, 2020

My answer: "This is classic for PE, but it can also be present in any hypoxia due pulmonary hypoxic vasoconstriction and resulting acute pulmonary hypertension and acute right heart strain. The ECG of most patients with longstanding pulmonary disease show more r wave progression than I see in ECG #1. This is NOT Wellens.

Chest Pain 52

Chest Pain Pulmonary Tachycardia Embolism 52

Dr. Smith's ECG Blog

JULY 3, 2020

The estimated pulmonary artery systolic pressure is 49 mmHg + RA pressure. It presents on the ECG as a long ST segment with resultant long QT == MY Comment by K EN G RAUER, MD ( 7/3/2020 ): == The patient in today’s case is a middle-aged woman who was brought to the ED following a motor vehicle accident.

Hemorrhage 52

Hemorrhage Critical Care Blood Pressure Laboratory 52