EKG advice

[Eric hall]

Hey guys I would appreciate if anyone can tell me if there is anything abnormal about this ekg, the monitor didn't have 12 lead ablity so it's just your standard 4 cable readout, any help or information would be greatly appreciated

 

[tpchristifulli]

Without a 12 it's hard to give you anything diagnostic. I would be suspicious of possible Left Ventricular Hypertrophy and some what appears to be S-T depression.

 

[captaindepth]

First, this is a zoomed in view of the EKG because the size is amplified by 1.5x.

The rhythm is normal sinus at 76 bpm with ST depression in the inferior leads (3-4 mm of depression but that is with the amplified tracing) and what looks like a hint of ST elevation in the high lateral leads. It would be nice to see the whole 12 lead and at a normal size.

 

[teedubbyaw]

Inferolateralseptalrightsided MI.

And a NSR.

 

[tpchristifulli]

I'm more interested in the blood stain on your couch?

 

[captaindepth]

Well that escalated quickly

 

[Eric hall]

Thanks for the replies so far, sorry for not having a 12-lead but it's not the best monitor device. Also, that isn't blood merely a stain from the kids lol, I had to double check when I read that however

 

[Eric hall]

I actually did manage to get a 12 lead to work, not sure why leads v1-v6 show up bolder than the rest, I'm not to familiar with zoll monitors.

 

[STXmedic]

60 cycle interference. Is this from a patient, or your own ECG? It sounds like the latter.

 

[Shishkabob]

NSR, LVH criteria present, ST-changes in inferior leads that are non-diagnostic.

 

[Eric hall]

Yeah it's the latter, it was plugged into a wall outlet charging, which seems to be a common issue.

 

[STXmedic]

Yeah it's the latter, anyway to correct for the interference?

Remove whatever electronic device is causing the interference, and take it to your cardiologist. We don't offer medical advice here.

 

[Anjel]

NSR, LVH criteria present, ST-changes in inferior leads that are non-diagnostic.

Woah there. Look who it is. I'm surprised you remembered your user name and password.

 

[Christopher]

Zoll M/E-Series often exhibit 60-cycle interference when plugged into the wall to charge. I recommend unplugging it or ensuring the notch filter is active. Reviewing the 12-Lead's printout I do not see any mention of a notch filter / mains filter.

The limb leads are recorded in monitor mode, which on a Zoll E/M is pretty aggressive. Something like 1 Hz high-pass and 21 Hz low-pass. This makes for a very distorted view of both amplitude and ST/T-waves. Real time high-pass filters "shift" some of the signal in time, unfortunately the portions of the signal they shift are the portions which have the highest amplitude.

The 12-Lead looks pretty normal to me, excluding the 60-cycle interference. Slight sinus arrhythmia with normal variant ST/T-wave changes.