ECG reading. HELP!

Published

CAN SOMEONE TELL ME WHAT THEY THINK? I AM HAVING A HARD TIME READING THIS ONE!

**NURSING STUDENT****

12115761_549669808515613_8085980821005443963_n.jpg?oh=174618d1c22bc928d7be901fe30670ae&oe=56CF1FDB

Up Vote Up Vote ×
Specializes in Public Health, TB.

Hard to be too specific, because I cannot see the lead or the boxes very well. It looks to be a SR, with a bundle branch block, possibly a 1st degree AV block. Without seeing the blocks clearly, I cannot determine the rate.

What did you think it was?

Up Vote Up Vote ×
Specializes in Critical Care, Med-Surg, Psych, Geri, LTC, Tele,.
Hard to be too specific, because I cannot see the lead or the boxes very well. It looks to be a SR, with a bundle branch block, possibly a 1st degree AV block. Without seeing the blocks clearly, I cannot determine the rate.

What did you think it was?

Some kind of block is what I thought, too. Thanks for that nursej22! I'm a student also.

Up Vote Up Vote ×
Specializes in Critical Care, Med-Surg.

I don't see any discernible block, but it is hard to see the gridlines. It looks like normal sinus to me, but the second lead may be showing some ST elevation.

Up Vote Up Vote ×

Patient had a stroke which caused bleeding in the brain. Patient died later that day.

Up Vote Up Vote ×
Hard to be too specific, because I cannot see the lead or the boxes very well. It looks to be a SR, with a bundle branch block, possibly a 1st degree AV block. Without seeing the blocks clearly, I cannot determine the rate.

What did you think it was?

I thought Normale saline with maybe ST elevation

Up Vote Up Vote ×
Specializes in Medical-Surgical/Float Pool/Stepdown.
I don't see any discernible block, but it is hard to see the gridlines. It looks like normal sinus to me, but the second lead may be showing some ST elevation.

There is a bundle branch block in which the tell tell is the widened QRS. Not the same as the first, second, or third degree blocks. I vote a sinus rythm with a BBB and a probable ST segment elevation/depression depending on which of the leads are being read. I prefer lead II. It's been a while but I think lead II shows the true deflections of the p wave, QRS, and t wave...but it's been a while!

Up Vote Up Vote ×
Specializes in Cath/EP lab, CCU, Cardiac stepdown.

Looks like sinus rhythm with st elevation to me

Up Vote Up Vote ×
Specializes in Cath/EP lab, CCU, Cardiac stepdown.

And maybe 1st degree block

Up Vote Up Vote ×
Specializes in Public Health, TB.

Bundle branch blocks can skew the morphology of the ST segment, leading to an ST elevation.

Up Vote Up Vote ×

P waves are not discernible. Needed to be re-done with better lead placement. May be a bundle branch block configuration, but that is a cardiologist's call. Highly doubt the stroke was related.

Up Vote Up Vote ×
Specializes in 15 years in ICU, 22 years in PACU.

Assuming the two leads are from the same patient.

Bottom lead clearly shows "p" waves = sinus rhythm.

17 little boxes between "qrs" complexes = HR 88 = Normal sinus rhythm.

"QRS" WIDTH = 3 little boxes = .12 = BBB

"PR int" = 4 little boxes = .20 = borderline First degree block

My call: NSR with BBB and borderline First degree AV Block.

Up Vote Up Vote ×
+ Join the Discussion