Case 3

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Revision as of 15:17, 11 November 2008 by Drj (talk | contribs) (Example 9 moved to Case 3)
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  • Following the 7+2 steps:
    • Rhythm
      • The ECG shows a regular rhythm with normal P waves (positive in I, III and AVF, negative in AVR), followed by QRS complexes. Sinusrhythm
    • Heart rate
      • 78 bpm
    • Conduction (PQ,QRS,QT)
      • PQ: 180ms QRS: 160ms QT: 370ms QTc: 420ms
    • Heartaxis
      • Negative in III, AVF and AVR, positive QRS complexes in I, II and AVL: horizontal heart axis
    • P wave morphology
      • The P waves have normal morphology.
    • QRS morphology
      • Wide QRS complexes with [[[LBBB|left bundle branch block]]] pattern.
    • ST morphology
      • ST elevation in V1-V3, AVR. ST depression in I, II, III, AVF, V4-6. The Sgarbossa criteria for ischemia in LBBB are not met (nog concordant ST deviation, no ST depression V1-V3, nog discordant ST elevation > 5 mm).
    • Compare with the old ECG (not available, so skip this step)
    • Conclusion?

Sinusrhythm with left bundle branch block, comparison with an old ECG is mandatory to evaluate whether the LBBB is new (a sign of myocardial infarction) or old.