{"id":442,"date":"2016-01-24T19:20:04","date_gmt":"2016-01-24T19:20:04","guid":{"rendered":"http:\/\/torreyekg.com\/?p=442"},"modified":"2016-01-24T19:11:35","modified_gmt":"2016-01-24T19:11:35","slug":"ekg-of-the-week-16","status":"publish","type":"post","link":"https:\/\/torreyekg.com\/index.php\/2016\/01\/24\/ekg-of-the-week-16\/","title":{"rendered":"EKG of the Week #16"},"content":{"rendered":"<p><a href=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/16.png\" rel=\"attachment wp-att-444\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone wp-image-444 size-full\" src=\"http:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/16.png\" alt=\"16\" width=\"647\" height=\"369\" srcset=\"https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/16.png 647w, https:\/\/torreyekg.com\/wp-content\/uploads\/2016\/01\/16-300x171.png 300w\" sizes=\"auto, (max-width: 647px) 100vw, 647px\" \/><\/a><\/p>\n<p>A 45-year-old man with a worsening chronic respiratory disease.<\/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 EKG gives the diagnosis\u2026and more!<\/p>\n<p><strong>Rate and rhythm:<\/strong> sinus at 110\/minute<br \/>\n<strong>Axis:<\/strong> right axis deviation at +120\u00b0<br \/>\n<strong>Intervals:<\/strong> PR, QRS, and QTc are normal<br \/>\n<strong>Chamber enlargement:<\/strong> the tall R wave in V1 and a right axis \u00e0 right ventricular hypertrophy<br \/>\n<strong>ST-segment and T-wave changes:<\/strong> T wave inversion in V1-3 is consistent with right ventricular strain pattern<\/p>\n<p>This EKG is a good example of how the differential of a tall R wave in lead V1 can be helpful (see \u201cTall R waves in V1\u201d under website section EKG discussion).<\/p>\n<p>Four causes of a tall R wave in V1 with their hints:<br \/>\nRBBB \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0QRS \u2265 0.11<br \/>\nWPW type A \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 delta wave and short PR interval<br \/>\nOld posterior MI \u00a0 \u00a0 \u00a0accompanies an old inferior MI<br \/>\nRVH \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 \u00a0 right axis deviation<\/p>\n<p>This EKG is from a patient with <u>primary pulmonary<\/u> <u>hypertension<\/u> and significant RVH.<\/p>\n<p>Notice the respiratory rate\u2026since the V1 lead is on the chest, the rhythm strip records the chest excursion. The respiratory rate is approximately 24\/minute!<\/p>\n<p><\/p><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>A 45-year-old man with a worsening chronic respiratory disease.<\/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-442","post","type-post","status-publish","format-standard","hentry","category-ekg-of-the-week"],"_links":{"self":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/442","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/comments?post=442"}],"version-history":[{"count":5,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/442\/revisions"}],"predecessor-version":[{"id":448,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/posts\/442\/revisions\/448"}],"wp:attachment":[{"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/media?parent=442"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/categories?post=442"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/torreyekg.com\/index.php\/wp-json\/wp\/v2\/tags?post=442"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}