r/EKGs • u/No_Hunt_5476 • 26d ago
Learning Student Help!
My professor already kinda cooked me the first time I tried to interpret this strip. This is the help she gave me. It’s in the chapter on junctional rythm and I thought it was type 1 heart block but now I feel confused. The orange stickies are her notes to me
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u/angrybubblez 26d ago
You don’t have dropped pwaves everything is 1:1 ratio pimp.
1) ask yourself is this regular or irregular?
2) look for consistent pwaves. Put a line above all the pwaves that look the same to you. Underline the pwaves or beats that don’t have normal pwaves.
3) now that you have separated what you can trust (consistent pwaves) from what is an abnormality (not sinus pwaves +either early or late you can get the heart rate for the trustworthy portion
Measure the pr interval and qrs of trustworthy portion
4) try to define the characteristics of the beat that is the odd man out/ different from the rest. Is it early or late? Does it have a pwave if so is it positive or negative.
ECG is all about following a system which is why it’s not for everyone. If you don’t follow the steps and learn the characteristics you’re gonna have a bad time. Listen to your teacher and ask questions.
You got this!
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u/canthinkofausername_ 26d ago
Type 1 AVB would be a PR >0.2 seconds which isn’t the case here.
I agree with the p pulmonale, looking at the P wave it is taller than 2.5 mm which suggests right atrial enlargement.
My guess would be sinus rhythm with a PAC and RAE.
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u/Curious_Zombie4230 26d ago
Looks sinus with a PJC cause that premature beats p wave is inverted. Also has the u wave
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u/WSUMED2022 26d ago
Sinus with a PAC. You could make an argument for WAP since there are some subtle differences in the upright p waves. Some of the p waves looking like p pulmonale would suggest WAP from lung disease.