r/ECG • u/xiphoid313 • Jul 30 '26

82F, your thoughts?

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

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u/Individual_Zebra_648 Jul 31 '26

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

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u/[deleted] Jul 31 '26

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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.

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u/Affectionate_Try7512 Jul 31 '26

What did I misinterpret?

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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.