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Advanced EKG patterns

Advanced EKG patterns. Upper Level Conference UNC Internal Medicine 10/21/09. Basics. Always examine an EKG systematically then come up with your interpretation. What is the abnormality?. LVH What are the criteria for LVH?. What is the axis?

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Advanced EKG patterns

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  1. Advanced EKG patterns Upper Level Conference UNC Internal Medicine 10/21/09

  2. Basics • Always examine an EKG systematically then come up with your interpretation

  3. What is the abnormality? • LVH • What are the criteria for LVH?

  4. What is the axis? What is the differential diagnosis for that axis? Left Anterior Fascicular Block 1. Criteria for LAFB?

  5. Describe this rhythm using your “tachycardia” algorithm: What rhythm is this? How do you know?

  6. Any regular wide complex tachydardia: • Brugada Criteria – helps you discern between VT and SVT with aberrancy • If ANY of the criteria are satisfied, its VT • If NO criteria is satisfied, its SVT with aberrancy

  7. Brugada criteria • Concordance in precordial leads • R to S interval > 100ms in a precordial lead • AV dissociation? • Morphology look like VT?

  8. Concordance (lack of RS complex in precordial leads)

  9. What are the abnormalities? What is the syndrome? Brugada syndrome – Inherited Na channel abnormality, can lead to sudden death

  10. In summary • Formal diagnosis of LVH • LAFB and LPFB • Approach to tachycardia • Distinguish between VT and SVT with aberrancy – Brugada criteria • Brugada syndrome

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