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76 Acute infero-postero-lateral MIHyperacute ST segment elevation is seen in leads II, III, aVF (inferior location) and in leads V4-6 (apical lateral wall location). Hyperacute ST depression is seen in leads V1-2 (an expression of posterior wall injury). in addition there are reciprocal ST segment depression changes in leads I an...Knowledge Weavers ECG
77 Ventricular Pacemaker Rhythm: V1-3Note the small pacemaker spikes before the QRS complexes. In addition, the QRS complex in V1-3 exhibits ventricular ectopic morphology; i.e., there is a slur or notch at the beginning of the S wave, and >60ms delay from onset to QRS to nadir of S wave. This rules against a supraventricular rhythm wi...Knowledge Weavers ECG
78 Inferior MI: fully evolvedSignificant pathologic Q-waves are seen in leads II, III, aVF along with resolving ST segment elevation and symmetrical T wave inversion. This is a classic inferior MI.Knowledge Weavers ECG
79 Complete AV block (3rd degree) with junctional rhythmComplete AV block (3rd degree) with junctional rhythmKnowledge Weavers ECG
80 QRS axis = +90 degreesLead I is isoelectric; II and III are positive; the axis is +90 degrees.Knowledge Weavers ECG
81 Left bundle branch block - marquetteLeft bundle branch block - marquetteKnowledge Weavers ECG
82 Junctional escape rhythmJunctional escape rhythmKnowledge Weavers ECG
83 Acetyl CoA structureAcetyl CoA Structure. The thioester bond linking the acetyl group to CoA is ahigh energybond.Knowledge Weavers Fatty Acids
84 Diagram: AV nodal reentrant tachycardiaThe AV node often has dual pathways; in this diagram the alpha pathway is fast, but has a long refractory period; the beta pathway is conducts more slowly, but recovers faster.In sinus rhythm the faster alpha pathway is used and accounts for the normal PR interval. When a PAC occurs, however, the i...Knowledge Weavers ECG
85 Atrial parasystoleIn atrial parasystole non-fixed coupled PACs, shown by arrows, occur at a common inter-ectopic interval or at multiples of this interval. Atrial fusions, not shown here, may also occur when the PAC occurs in close temporal proximity to the sinus impulse.Knowledge Weavers ECG
86 Use of greek letters to designate carbons in fatty acidsThe carbon next to the -COOH group is the alpha carbon; the next one is the beta carbon, and so forth. The carbon most distant from the -COOH group is designated omega. Carbons close to the omega carbon may be designated in relation to it. E.g., the third carbon from the end is omega - 3, and the...NomenclatureKnowledge Weavers Fatty Acids
87 Atrial flutter with 2:1 conduction: leads II, III, V1Atrial flutter with 2:1 conduction: leads II, III, V1Knowledge Weavers ECG
88 Pacemaker lead wire placement diagram - marquettePacemaker lead wire placement diagram - marquetteKnowledge Weavers ECG
89 Frontal and horizontal plane lead diagramFrontal and horizontal plane lead diagramKnowledge Weavers ECG
90 ST segment diagram - marquetteST segment diagram - marquetteKnowledge Weavers ECG
91 Atrial bigeminy - marquetteAtrial bigeminy - marquetteKnowledge Weavers ECG
92 Right Bundle Branch BlockRight Bundle Branch BlockKnowledge Weavers ECG
93 2nd degree AV block, type I, with accelerated junctional escapes and a ladder diagramThe ladder diagram illustrates a Wenckebach type AV block by the increasing PR intervals before the blocked P wave. After the blocked P wave, however, a rev-ed up junctional pacemaker terminates the pause. Note that the junctional beats have a slightly different QRS morphology from the sinus beats...Knowledge Weavers ECG
94 Atrial tachycardia with exit block and AV blockThe ectopic P waves, easily seen in this example,occur in groups, separated by short pauses. This is likely due to an exit block just distal to the atrial pacemaker. Because not all of the P waves make it to the ventricles, there is also 2nd degree AV block. Therefore, two levels of block are pre...Knowledge Weavers ECG
95 LVHIn this example of LVH, the precordial leads don't meet the usual voltage criteria or exhibit significant ST segment abnormalities. The frontal plane leads, however, show voltage criteria for LVH and significant ST segment depression in leads with tall R waves. The voltage criteria include 1) R in a...Knowledge Weavers ECG
96 A nonconducted PAC causes an unexpected pauseUnexpected pauses in rhythm have several causes, the most frequent being a nonconducted PAC. In this example the nonconducted PAC is seen in the ST segment of the pause. Note the change in the ST-T compared to the other ST-T waves.Knowledge Weavers ECG
97 Giant TU fusion wavesTU fusion waves are often seen in long QT syndromes. The differential diagnosis of this ECG abnormality includes electrolyte abnormalities -hypokalemia, CNS disease, e.g., subarachnoid hemorrhage; hereditary long QT syndromes, and drugs such as quinidine.Knowledge Weavers ECG
98 Left anterior fascicular block (LAFB)LAFB is the most common of the intraventricular conduction defects. It is recognized by 1) left axis deviation; 2) rS complexes in II, III, aVF; and 3) small q in I and/or aVL.Knowledge Weavers ECG
99 Atrial flutter with 2:1 AV conduction: lead V1The arrows point to two flutter waves for each QRS complex. Atrial rate = 280; ventricular rate = 140.Knowledge Weavers ECG
100 Long QT Interval and Giant Negative T WavesLong QT Interval and Giant Negative T WavesKnowledge Weavers ECG
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