{"id":449,"date":"2016-01-31T00:01:19","date_gmt":"2016-01-31T00:01:19","guid":{"rendered":"http:\/\/torreyekg.com\/?p=449"},"modified":"2016-01-24T19:15:15","modified_gmt":"2016-01-24T19:15:15","slug":"ekg-of-the-week-17","status":"publish","type":"post","link":"http:\/\/torreyekg.com\/index.php\/2016\/01\/31\/ekg-of-the-week-17\/","title":{"rendered":"EKG of the Week #17"},"content":{"rendered":"<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/17.png\" rel=\"attachment wp-att-451\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-451 size-full\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/17.png\" alt=\"17\" width=\"648\" height=\"355\" srcset=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/17.png 648w, http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/17-300x164.png 300w\" sizes=\"auto, (max-width: 648px) 100vw, 648px\" \/><\/a><\/p>\n<p>65-year-old man with substernal chest pain.<\/p>\n<div class=\"spoiler-wrap\"><div class=\"spoiler-head collapsed\" title=\"Expand\">Interpretation &amp; Explanation<\/div><div class=\"spoiler-body\" style=\"display: none;\">\n<p>This gentleman had chest pain and associated symptoms suggestive of an acute coronary syndrome. His EKG reveals STEMI in leads V<sub>2 <\/sub>\u2013 V<sub>5<\/sub>. This is an important pattern to recognize. A RBBB does not perturb the depolarization very much (because the RBBB supplies the much smaller side of the heart), certainly much less than LBBB. Because the depolarization is less altered it is expected that ST-segment changes of acute ischemia or infarct will be recognizable on the EKG.<\/p>\n<p>If there are any questions about the ST-segment elevation in V<sub>2-3<\/sub> remember that the horizontal tracings on the 12-lead are simultaneously recorded, and that complexes line up vertically. The beginning and the end of the QRS is clear in V<sub>1<\/sub>, and if you follow the end of this QRS down through V<sub>2-3<\/sub>, the ST-segment in these complexes becomes clear \u2013 it is not just a wide QRS in these leads!<\/p>\n<p>Another RBBB with acute anterior STEMI \u2013 perhaps more clearly seen<br \/>\n<a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/172.png\" rel=\"attachment wp-att-453\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-453 size-full\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/172.png\" alt=\"172\" width=\"431\" height=\"252\" srcset=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/172.png 431w, http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/172-300x175.png 300w\" sizes=\"auto, (max-width: 431px) 100vw, 431px\" \/><\/a><\/p>\n<p><\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>65-year-old man with substernal chest pain.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-449","post","type-post","status-publish","format-standard","hentry","category-ekg-of-the-week"],"_links":{"self":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/449","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/comments?post=449"}],"version-history":[{"count":3,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/449\/revisions"}],"predecessor-version":[{"id":454,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/449\/revisions\/454"}],"wp:attachment":[{"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=449"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=449"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=449"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}