In order to win this competition, please submit the appropiate diagnosis, including the rhythm.
HINT: The chest leads on this EKG are R precordial
If more than one person submits appropiate answer, the winner of the $25 gift card will be elected by lottery.
SORRY GUYS BUT NO ONE GOT THE COMPLETE ANSWER, AS DESCRIBED BY VALENTIN THERE ARE P WAVES EMBEDDED IN THE T WAVES, AND THIS PATIENT HAS 2ND DEGREE AV BLOCK WITH CONDUCTION 2:1, WHICH CAN HAPPEN IN PATIENTS WITH PROXIMAL OCCLUSION OF THE RCA. THE ST ELEVATION ON II, III, AVF GIVES THE DIAGNOSIS OF INFERIOR WALL MI, THEN R PRECORDIAL LEADS WERE DONE LOOKING FOR EVIDENCE OF RV INFARCTION, ST ELEVATION IN V4R DEMONSTRATES THAT THERE IS RV INFARCTION.
ANSWER:
INFERIOR WALL STEMI WITH RV INFARCTION, 2ND DEGREE AV BLOCK WITH CONDUCTION 2:1
December 4, 2009 at 11:07 am
so didn’t valentin get it right? give him his money!
December 3, 2009 at 10:07 pm
Brugada syndrome with coved ST segment elevations with first degree block and sinus bradycardia.
I know this seems like wild guess!! But RVMI is just too easy to be on a medicine blog!!
December 3, 2009 at 2:26 pm
1st degree AV Block.
December 2, 2009 at 10:53 am
Inferior/ right STEMI with reciprocal changes
Rhythm – if you ask (I will probably overlook it) is kind of slow HR <50 and I may see an P wave embedded in the T wave in V1 (kind of in the middle of the obvious P-P interval)—so I will put my 25 dollars on second degree AV block type 2 with 2:1 conduction (can happen in inferior MI)
December 1, 2009 at 11:48 pm
sinus brady ~48 w/ 1st degree block and acute proximal RCA occlusion
December 1, 2009 at 11:42 pm
Sinus brady with 1st degree AV block and RV/inferior STEMI. Axis is normal (unipolar/bipolar leads are placed normally in a right sided ecg)
November 25, 2009 at 3:24 pm
Sinus Bradycardia with 1st degree AV block; LAD; Inferior wall/RV STEMI. ST elevations in V5-V6 (Rt sided leads)represent RVMI.
November 25, 2009 at 2:07 am
First degree AV block, sinus bradycardia, Inferior and right ventricular STEMI.
November 24, 2009 at 9:54 am
Right ventricular MI with 1st degree AV block and sinus bradycardia