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Ken Grauer, MD
MARCH 27, 2024
This leaves us with the usual differential diagnosis for this rhythm presentation ( as per ECG Blog #361 ) ==> We need to consider i ) VT until proven otherwise: ii ) SVT with either preexisting BBB or aberrant conduction; — or , iii ) Something else ( ie, WPW, hyperkalemia, some other toxicity, etc. ). What Kind of Conduction Defect?
Ken Grauer, MD
MARCH 1, 2024
PEARL # 2: As described in ECG Blog #394 — QRS widening in the presence of sinus rhythm, in which QRS morphology is consistent with RBBB conduction in the chest leads — but LBBB conduction in the limb leads ( especially with a leftward axis ) — suggests the entity known as MBBB ( M asquerading B undle B ranch B lock ).
Ken Grauer, MD
DECEMBER 23, 2023
By the P s, Q s, 3 R Approach ( See ECG Blog #185 ): The rhythm is fast and QRS complexes are R egular. PEARL # 4: As emphasized in ECG Blog #204 , in which I review derivation of the bundle branch blocks — RBBB is a terminal conduction delay. ECG Blog #185 — Reviews the P s, Q s, 3 R Approach to Rhythm Interpretation.
Ken Grauer, MD
JANUARY 5, 2024
Regarding the 1 2- L ead E CG: Applying the systematic approach I favor for 12-lead ECG interpretation ( as detailed in ECG Blog #205 ): Rate & Rhythm: As stated above — there is a regular, supraventricular rhythm with some P waves, group beating, and an acceptable overall ventricular rate between ~60-80/minute. I begin with Figure-5.
Ken Grauer, MD
NOVEMBER 10, 2023
For full discussion of this case — See ECG Blog #220 — == The long lead II rhythm strip shown in Figure-1 was obtained from an 51-year-old man who presented to the ED ( Emergency Department ) with "palpitations" that began 1 hour earlier. Figure: Use of the "3 Simple Rules" for distinction between SVT vs VT ( taken from ECG Blog #196 ).
Ken Grauer, MD
OCTOBER 10, 2024
I say this for the simple reason that to pick any of the above 4 choices — is to imply with 100% certainty that you know the answer ( or, as is implied in the title of today’s Blog post — this would be premature closure). ECG Blog #240 — The regular SVT. ECG Blog #229 — Why is AFlutter so commonly overlooked? s in Figure-2 ).
Ken Grauer, MD
APRIL 20, 2024
As is also emphasized often in this ECG Blog — spontaneous reperfusion of the "culprit" artery is common — and, IF this occurs before a 2nd ECG is done, ST-T wave changes may "look better" ( See References to related Blog posts below ). ECG Blog #294 — Reviews how to tell IF the " culprit " artery has reperfused.
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