Brugada Syndrome

Brugada Syndrome is an ECG abnormality with a high incidence of sudden death in patients with structurally normal hearts. First described in 1992 by the Brugada brothers, the disease has since had an exponential rise in the numbers of cases reported. The mean age of sudden death is 41, with the age at diagnosis ranging... Continue Reading →

3rd Degree Heart Block

3rd Degree Heart Block (Complete Heart Block) Overview In complete heart block, there is complete absence of AV conduction – none of the supraventricular impulses are conducted to the ventricles. This one minute video shows what is happening really well. A perfusing rhythm is maintained by a junctional or ventricular escape rhythm as Chris explained in the WhatsApp group. Failing this,... Continue Reading →

Wellens Syndrome

Last week Valentino posted this ECG for discussion and talked about Wellens syndrome and how to spot it. Below is information taken from LITFL about the clinical significance of Wellens and what the diagnostic criteria are. Wellens syndrome is a pattern of deeply inverted or biphasic T waves in V2-3, which is highly specific for a critical... Continue Reading →

Left Bundle Branch Block (LBBB)

Normally the septum is activated from left to right, producing small Q waves in the lateral leads.In LBBB, the normal direction of septal depolarisation is reversed (becomes right to left), as the impulse spreads first to the RV via the right bundle branch and then to the LV via the septum.This sequence of activation extends the QRS... Continue Reading →

The Cardiac Conduction Cycle

Before starting to look at ECGs, it is important to understand the mechanics and electrics of what exactly is going on in the heart. Let's look at the human body's vessels and organs as a central heating system. Your heart is the boiler, your vessels as the pipes and the radiators as your organs. In your... Continue Reading →

ECG – The Basics

To understand how to read an ECG and the terminology involved, it is essential you have a good idea of the cardiac conduction system. If you haven't already, give the last post 'The Cardiac Conduction System' a quick read. There is a useful short video that explains it really well!  To recap on that electrical... Continue Reading →

High-take off or ST elevation?

Clinical Relevance High-take off (AKA benign early repolarisation; J-point elevation) is an ECG pattern most commonly seen in young, healthy patients < 50 years of age. It produces widespread ST segment elevation that may mimic pericarditis or acute MI.Up to 10-15% of ED patients presenting with chest pain will have high-take off on their ECG,... Continue Reading →

Anteroseptal STEMI

Today we looked at an ECG showing an Anteroseptal STEMI. We looked at the features of this ECG and the management within the department.   ECG Example:   ECG roundup: - ST elevation is biggest in the anteroseptal leads (V1-4). - There is some subtle ST elevation in I, aVL and V5, with reciprocal ST depression in lead III.-... Continue Reading →

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