#rightsidedhf #diagnosis #cardiology

A mnemonic / aide memoir to facilitate in the teaching / learning of >20 STEMI mimics. Please follow the link for the presentation exploring each mimic in detail. #STEMI #mimics #mneomnic #differential #diagnosis #cardiology #mimickers

Skin Mottling - Staging 1 - Modest mottling area (coin size) 2 - Moderate area that does not extend past superior edge of patella 3 - Does not exceed middle thigh 4 - Severe that does not extend beyond groin fold 5 - Goes beyond groin fold #Skin #Mottling #Staging #Clinical #Diagnosis #Stages #Clinical

Arterial Blood Gas (ABG) Analysis - Metabolic + Respiratory Acidosis + Alkalosis pH ↓ pCO2 ↓ - Metabolic acidosis pH ↑ pCO2 ↑ - Metabolic alkalosis pH ↑ pCO2 ↓ - Respiratory alkalosis pH ↓ pCO2 ↑ - Respiratory acidosis #Arterial #BloodGas #ABG #Analysis #Interpretation #AcidBase #Diagnosis #Compensation #acidosis #alkalosis

EKG Interpretation Cheat Sheet 1) Rate - Regular - Count-Off - Irregular - Count number of QRS in 10s x 6 2) Rhythm 3) Axis 4) Alphabet - Width? Height? Shape? (Up/Down, Contour) P Waves: • Inverted P Waves (in inferior leads)? • PR interval < 120 ms = AV junction origin (e.g. accelerated junctional rhythm) • PR interval ≥ 120 ms, origin within the atria (e.g. ectopic atrial rhythm) • Variable P-Wave Morphology = multifocal atrial rhythm • No P Waves/Fibrillary = afib • Saw-Tooth = Atrial Flutter PR Interval: • 1° Block - PR >200ms • 2° Block Type I - PR ↑ incrementally before loss of P • 2° Block Type II - Suddenly Lose P • 3° Complete Block (nothing getting through) QRS Complex: • Pathological Q waves: > 40 ms (1 mm) wide > 2 mm deep or > 25% of depth of QRS complex Seen in leads V1-3 (Right sided leads) • R wave abnormalities: Dominant R wave in V1 Dominant R wave in aVR Poor R wave progression ST Segment: • Septal (V1-2) • Anterior (V3-4) • Lateral (I + aVL, V5-6) • Inferior (II, III, aVF) • Right ventricular (V1, V4R) • Posterior (V7-9) T Waves: • Normal: Upright in all leads except aVR and V1 (Invert III normal variant), Amplitude < 5mm in limb leads, < 15mm in precordial leads • Hyperacute T waves Inverted T waves, Biphasic T waves, ‘Camel Hump’ T waves, Flattened T waves QT/QTC Interval: • QT interval is inversely proportional to heart rate • Bazett formula: QTC = QT / √ RR - Note: there are multiple QTc correction formulas • Prolonged QTc > 440ms in men, > 460ms in women • QTc > 500 is associated with increased risk of torsades de pointes • Short QTc < 350ms • Rule of thumb: a normal QT is less than half the preceding RR interval Other: • U waves = severe hypokalaemia or bradycardia • J /Osborn wave (between QRS and ST) = hypothermia • Delta Wave (before QRS) = WolffParkinson-White syndrome • Epsilon Wave (blip QRS) = Arrhythmogenic right ventricular dysplasia (ARVD) - Amy Chung, MD, MSc @AmyChung #EKG #Interpretation #ECG #Electrocardiogram #cardiology #diagnosis #system #cheatsheet