1 / 6

67 yom presents after syncope (while going to restroom). Mild dyspnea, no CP, BP 110/70

67 yom presents after syncope (while going to restroom). Mild dyspnea, no CP, BP 110/70. ECG findings. Sinus tachycardia with frequent PACs Right axis : net QRS is (-) in lead I; QRS is closest to equiphasic in lead aVF  axis close to +180 degrees RAE (by lead II and lead V1 criteria)

braima
Download Presentation

67 yom presents after syncope (while going to restroom). Mild dyspnea, no CP, BP 110/70

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 67 yom presents after syncope (while going to restroom). Mild dyspnea, no CP, BP 110/70

  2. ECG findings • Sinus tachycardia with frequent PACs • Right axis : net QRS is (-) in lead I; QRS is closest to equiphasic in lead aVF axis close to +180 degrees • RAE (by lead II and lead V1 criteria) • S>R in V6 + Right axis deviation RVH • S1Q3T3 c/w right axis (big S in lead I) and RVH • T inversion in V1-V3: ddx: anterior ischemia vs RV strain Final dx: PE with signs of RV/RA overload

  3. How to assess QRS axis? 1st step: Look in leads I and aVf, and potentially in lead II if needed 2nd step (not very important for residents): See where QRS is closest to isoelectric, the axis is 90 degrees perpendicular to it in the corresponding quadrant

  4. RV enlargement leads to increased R wave height in the right-sided lead V1 and increased S wave in the left-sided lead V6

More Related