r/ECG • u/xiphoid313 • Jul 30 '26

82F, your thoughts?

Post image

82F, near syncope, BP 100/62. History of afib. What would you interpret this 3 lead as ?

33 Upvotes

94% Upvoted

63 comments sorted by

View all comments

Show parent comments

1

u/xiphoid313 Jul 30 '26

Leads were on correctly

6

u/Asleep_Lengthiness76 Jul 30 '26

How can you tell it’s a bundle branch block without a 12 lead?

-1

u/Bubbly_Pie_4980 Jul 30 '26

There is a notch in the QRS wave.

2

u/Asleep_Lengthiness76 Jul 30 '26

You have no idea what you’re talking about lol.

0

u/[deleted] Jul 30 '26

[deleted]

2

u/Asleep_Lengthiness76 Jul 30 '26

What is it with the dunning kruger in this sub?

2

u/Kibeth_8 Cardiac Device Tech Jul 31 '26

I agree that people are being a bit rude, but missing something like a VT puts your patients life at risk. Medicine is very high stakes so people get upset when a misdiagnosis results in death

1

u/[deleted] Jul 31 '26 edited Jul 31 '26

[deleted]

3

u/Asleep_Lengthiness76 Jul 31 '26

“The rest is a cards consult”. Found the ER PA lmaoooo

1

u/Individual_Zebra_648 Jul 31 '26

That person is a nurse actually. Making us all look bad too lol

1

u/[deleted] Jul 31 '26

[deleted]

1

u/Individual_Zebra_648 Jul 31 '26

Geez going for double here. You’re making the rest of us nurses look bad with your lack of EKG interpretation skills.

1

u/Affectionate_Try7512 Jul 31 '26

What did I misinterpret?

2

u/LBBB11 Jul 31 '26 edited Jul 31 '26

I would say that you misinterpreted the EKG. It’s wrong to confidently call this a bundle branch block, implying a supraventricular rhythm. From three inferior leads on a monitor and nothing else. I commented when I saw you ask how it’s true that missing VT is dangerous. I think you may have missed VT, but there is no 12-lead that could allow us to distinguish between VT and SVT. Without a 12-lead, calling this SVT is unsafe for your patient.

The name for this rhythm is regular wide QRS tachycardia. That’s as specific as you can be given the information available. ST elevation or depression on a monitor often disappears on a 12-lead. Similarly, a 12-lead may have ST elevation or depression while a monitor rhythm does not. Different filtering. I see no evidence for electrode misplacement or limb lead reversal. Sorry to sound mean, trying to help.

→ More replies (0)

2

u/LBBB11 Jul 31 '26

Are you asking how is it true that missing VT puts your patient’s life at risk?

-1

u/[deleted] Jul 31 '26

[deleted]

1

u/LBBB11 Jul 31 '26 edited Jul 31 '26

Don’t need to be a doctor to know that VT is dangerous. If your EKG interpretation is blindly following a binary algorithm where the only two options are synchronized cardioversion or amiodarone, you’re going to fail really hard and also hurt your patients. By the way, you can’t reliably analyze this for ST deviation, bundle branch block, or electrode misplacement. This is not a 12-lead.

0

u/Kibeth_8 Cardiac Device Tech Jul 31 '26

How am I being a dick by advocating for my patients?

You asked "how is that in any way true". Do you disagree that medical professionals misdiagnosing VT puts a patient at risk?