Nurse Practitioner ECG practice

  1. I thought it might be good practice for us to have an interesting clinical problem each week. Maybe even more often.

    Look at this ECG and decide what you think. Infero-lateral infarct, acute inferior infarct with right ventricular involvement or normal ECG.



    You can give your rationale if you so choose. If not, it will be given later.

    Good luck and have fun!!!!!!!!!
    Last edit by sirI on Aug 23, '05
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  2. 30 Comments

  3. by   sirI
    Any cardiac-types out there that want to take a look and answer?

    Come on guys..........gotta be a few out there that want to take the plunge and answer this. :wink2:
  4. by   ckh23
    Infero-lateral
  5. by   hrtprncss
    anterolateral with inferior involvement, but what happened to lead II I cant' see any elevation there ughhhhhh i need to review my 12 lead!!!
  6. by   sirI
    This is not the easiest strip to evaluate, I know. Tricky. Do you think I would give you something easy?

    Ya'll keep on with the replies. I will let you know what the answer is and the rationale.

    Good work!!!!!!!!!! :Melody:
  7. by   carachel2
    Inferolateral with right ventricular involvement. I am hesitant to say that because there is no ST elevation in V2 or Lead 2 .....????

    The ST segments look kind of concave in their elevation and would make me curious about a pericarditis process....but that is probably reading way too much into the problem.
  8. by   sirI
    My you guys are doing great.

    There is a right on answer there from one of ya'll so far..
  9. by   lyela
    acute inferior infarct with right ventricular involvement.
  10. by   hrtprncss
    wouldn't the st waves be more global if it was pericarditis meaning more apparent to most or all the leads...correct me if im wrong
  11. by   sirI
    The ST segments are very interesting in this strip giving one reason to suspect pericarditis.
  12. by   sirI
    Must remember if pericarditis, the ST segments would most probably be elevated all around in multiple leads and VERY global concavity.
  13. by   carachel2
    Siri...is this your daughter's EKG ? Just curious.
  14. by   sirI
    Quote from carachel2
    Siri...is this your daughter's EKG ? Just curious.
    No, thank goodness.

    She had MANY runs of V-Tach and Bigeminy, however. I should crop hers and give it as a clinical case, huh?

    She is doing fairly well now. I hope things calm down. You know she did not have SVT. The ablation was not successful.

    She has total left ventricular involvement.

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