QRS/ST Segment Practice Tracings

Nick Sparacino, DO

78 y/o female with UTI

Bonus ?: where is the borderline 1st degree av block located?

78 y/o female with UTI

Large S in inferior leads + >-45 degree

axis = LAFB

RsR’ pattern in frontal leads (V1/V2)

= RBBB

=+ Bifascicular block

65 y/o male with inferoposterior MI 6 years ago

65 y/o male with inferoposterior MI 6 years ago

RsR’ pattern in frontal leads (V1/V2) = RBBB

qR pattern in II, III, aVF = LPFB

+ Bifascicular Block=

48 y/o male on dialysis

48 y/o male w/ htn on dialysis, no cardiac symptoms

Depressed, inverted T waves progressing laterally + large (-) deflection in V1 p wave + history of dialysis and htn = most likely LVH

82 y/o female with a fib, ICM, EF 20%,now with subacute increase in

fatigue, sob, edema

82 y/o female with a fib, ICM, EF 20%,now with subacute increase in

fatigue, sob, edema

Dig effect -> depressed lateral ST, inverted lateral T. History of a fib and ischemic cmo make dig a likely drug

68 y/o male with left chest pain, TIMI 5, trop (-) x 2

68 y/o male with left chest pain, TIMI 6, trop (-) x 2

Biphasic ST-T’s in V2/V3, progressively more flattened laterally in high risk pt with negative trop = worry about Wellens!

35 y/o f 1 year sob, severe GERD

Tall R in frontal leads, ST depresseion in frontal leads, large S in lateral leads =RVH tall peaked P in II denotes RAH, demonstrating chronic/severe

RVH. With history of GERD, consider primary pulm hypertension with scleroderma spectrum disease

35 y/o f 1 year sob, severe GERD