The 360 Degree Heart – Part II

The first post in our “360 Degree Heart” series attempted to visualize how the different frontal plane (limb) leads relate to one another. We also introduced the concept of “negative leads,” which are just the standard leads flipped upside down. If you didn’t read that post it would probably be helpful to start there. This week we’re going to review another cases that emphasize how the simple concepts behind the “360 Degree Heart” can improve your EKG reading. As luck would have it, I stumbled upon the perfect addition to this series soon after writing up Part I. Many thanks to Rom Duckworth for letting me use this EKG in our little educational endeavor. He’s the editorial director at Rescue Digest, plus he’s got some great slide-sets up for browsing on SlideShare (which is where this particular tracing caught my eye).   This ECG shows a subtle acute postero-lateral STEMI   One glance at this ECG tells me that this patient has an acute obstruction of their left circumflex coronary artery (LCx). Though this does not meet the formal, oft-maligned “millimeter criteria” of 1 mm or more in two contiguous leads, this is a legitimate STEMI-equivalent. There is acute occlusion or near-occlusion of a major coronary artery and this patient requires immediate intervention for the best chance at an optimal outcome. How can I say this with such confidence? Perhaps you noticed the ST-depression from V2-V4, i...
Source: EMS 12-Lead - Category: Cardiology Authors: Tags: 360 Degree Heart Series 12-Lead ECG axis determination cardiac axis case study Vince DiGiulio why learn axis determination? why learn axis? Source Type: research