Discover and read the best of Twitter Threads about #EKG
Most recents (20)
🫀⚡️CTI-Blockade bei rechtsatrialemp #Vorhofflattern war eine meiner ersten eigenen Prozeduren in der EP und bleibt bis heute eine faszinierende Untersuchung.
Doch wie war das nochmal mit dem Flattern und dem CTI - ein kleiner 🧵, nicht nur für #EPeeps
#FOAMed #CardioTwitter
Doch wie war das nochmal mit dem Flattern und dem CTI - ein kleiner 🧵, nicht nur für #EPeeps
#FOAMed #CardioTwitter
Rechtsatriales Vorhofflattern basiert auf einem Makroreentry im rechten Vorhof und rotiert entweder gegen den ⏰ („typisches Vorhofflattern“) oder mit dem ⏰ um den Trikuspidalklappenannulus (TKA).
Der Begriff Makroreentry beschreibt eine kreisende elektrische Aktivierung rund um ein großes Hindernis, den TKA – schön zu erkennen im elektroanatomischen Map ⬆️👆🏻
1/ Let’s talk about focal atrial tachycardia #CardioTwitter.
🧵👇 by @ekgdx
#ekgdx #ecg #ekg #MedTwitter #medicine #medstudents #basic #education #graphic
🧵👇 by @ekgdx
#ekgdx #ecg #ekg #MedTwitter #medicine #medstudents #basic #education #graphic
2/ Focal atrial tachycardia is characterized by at least three or more consecutive ectopic P waves with similar morphology, usually arising from a single ectopic focus.
#ekgdx
#ekgdx
3/ Criteria
✅ ≥3 consecutive similar ectopic P waves (usually inverted in inferior leads).
✅ Atrial rate >100 bpm.
✅ QRS usually narrow unless pre-existing BBB or aberrant conduction.
#ekgdx
✅ ≥3 consecutive similar ectopic P waves (usually inverted in inferior leads).
✅ Atrial rate >100 bpm.
✅ QRS usually narrow unless pre-existing BBB or aberrant conduction.
#ekgdx
Are you a #juniordoctor or #medstudent?
Here's 10 great FREE modules to help get you started on the wards!
#meded #medschool #tipsfornewdocs #juniordocs #FOAMed #medtwitter #medstudenttwitter #juniordoctors #medstudents
Here's 10 great FREE modules to help get you started on the wards!
#meded #medschool #tipsfornewdocs #juniordocs #FOAMed #medtwitter #medstudenttwitter #juniordoctors #medstudents
Occasionally you'll need to perform sterile procedures. Make sure you prepare the best you can
osler.app.link/CztXIRjyntb
osler.app.link/CztXIRjyntb
Providing basic life support is a core skill for all healthcare staff
osler.app.link/u4fe8uqyntb
#basiclifesupport #bls #FOAMresus #resuscitation
osler.app.link/u4fe8uqyntb
#basiclifesupport #bls #FOAMresus #resuscitation
1/ Let’s talk about the ST segment #CardioTwitter.
ST segment normally represents the interval between ventricular depolarization and repolarization.
Normal ST
✅ Usually isolectric or may vary from 0.5 mm below to 1 mm above isolectric line in L leads.
#ekgdx #Medicine
ST segment normally represents the interval between ventricular depolarization and repolarization.
Normal ST
✅ Usually isolectric or may vary from 0.5 mm below to 1 mm above isolectric line in L leads.
#ekgdx #Medicine
2/ ST elevation (STE)
ST changes suggesting myocardial injury:
✅ New STE ≥1 mm in all leads other than V2 or V3.
✅ New STE in V2-V3 ≥2 mm in men older than 40 years old and ≥2.5 mm in men younger than 40 years old or ≥1.5 mm in women.
#ekgdx #Medstudent #MedTwitter
ST changes suggesting myocardial injury:
✅ New STE ≥1 mm in all leads other than V2 or V3.
✅ New STE in V2-V3 ≥2 mm in men older than 40 years old and ≥2.5 mm in men younger than 40 years old or ≥1.5 mm in women.
#ekgdx #Medstudent #MedTwitter
3/ Types of ST segment elevation include:
✅ Convex Upward (previous pic)
✅ Horizontal (this one)
✅ Concave Upward (see next)
✅ Obliquely Straight (see next)
#ekgdx #st #MedTwitter #ecg #ekg #CardioTwitter #Medstudent
✅ Convex Upward (previous pic)
✅ Horizontal (this one)
✅ Concave Upward (see next)
✅ Obliquely Straight (see next)
#ekgdx #st #MedTwitter #ecg #ekg #CardioTwitter #Medstudent
Three #cardiology cases with diagnostic ECGs in our resus room today and some learning points for emergency clinicians
#ecg #ekg
#ecg #ekg
1. Sudden onset palpitations
ECG shows regular narrow complex tachycardia with rate around 140
ECG shows regular narrow complex tachycardia with rate around 140
We suspected this was atrial flutter
Rather than subject a patient to the horror of iv adenosine (which only reveals flutter - it can’t convert it), we moved the ECG limb leads around to get a ‘Lewis lead’ which better shows atrial activity
(See litfl.com/lewis-lead-s5-… )
Rather than subject a patient to the horror of iv adenosine (which only reveals flutter - it can’t convert it), we moved the ECG limb leads around to get a ‘Lewis lead’ which better shows atrial activity
(See litfl.com/lewis-lead-s5-… )
1/ Let’s talk about P waves #CardioTwitter.
The P wave is the first positive deflection on the EKG and represents atrial depolarization. The first half represents right atrial depolarization and the second half represents left atrial depolarization.
By @ekgdx
The P wave is the first positive deflection on the EKG and represents atrial depolarization. The first half represents right atrial depolarization and the second half represents left atrial depolarization.
By @ekgdx
2/ Normal P wave
Criteria
✅ Axis: 0° to +75°.
✅ Amplitude (L leads): <2.5 mm.
✅ Amplitude (P leads): <1.5 mm.
✅ Duration: 0.08 - 0.11 sec.
✅ Morphology: Upright in I, II, aVF and inverted in aVR.
#Pwaves #ecg #ekg #ekgdx #medicine #MedTwitter #MedStudentTwitter #basic
Criteria
✅ Axis: 0° to +75°.
✅ Amplitude (L leads): <2.5 mm.
✅ Amplitude (P leads): <1.5 mm.
✅ Duration: 0.08 - 0.11 sec.
✅ Morphology: Upright in I, II, aVF and inverted in aVR.
#Pwaves #ecg #ekg #ekgdx #medicine #MedTwitter #MedStudentTwitter #basic
3/ Peaked P wave
The morphology is peaked with amplitude ≥2.5 mm, usually in II, III and aVF.
The peaked P wave is a typical characteristic of right atrial abnormality/enlargement.
Causes: PE, COPD, congenital heart disease, pulmonary hypertension, normal variant, others.
The morphology is peaked with amplitude ≥2.5 mm, usually in II, III and aVF.
The peaked P wave is a typical characteristic of right atrial abnormality/enlargement.
Causes: PE, COPD, congenital heart disease, pulmonary hypertension, normal variant, others.
Acute pulmonary embolism (PE) is one of the most serious form of venous thromboembolism. The clinical presentation of PE is variable and often nonspecific making the diagnosis challenging.
1/
#CardioTwitter
1/
#CardioTwitter
Criteria
✅ Sinus tachycardia (most common).
✅ S1Q3T3 pattern (may be present up to 30% of cases).
✅ Simultaneous T wave inversions in the inferior leads and right precordial leads can be seen.
✅ Right axis deviation.
✅ RBBB (complete or incomplete).
2/
#MedTwitter #ecg
✅ Sinus tachycardia (most common).
✅ S1Q3T3 pattern (may be present up to 30% of cases).
✅ Simultaneous T wave inversions in the inferior leads and right precordial leads can be seen.
✅ Right axis deviation.
✅ RBBB (complete or incomplete).
2/
#MedTwitter #ecg
Hey #OhGottPJ - Ihr seid alleine in der ZNA und seht diesen Monitorausschnitt - was passiert da? Und was jetzt? :D
#ekg #ecg #cardiotwitter
#ekg #ecg #cardiotwitter
Man sieht irgendwas, was zu einer Breitkomplextachykardie umspringt in der Monitorüberwachung.
1. Wir sind uns ja relativ einig es handelt sich um einen potentiellen Notfall also:
In case of emergency, take your own pulse first!
1. Wir sind uns ja relativ einig es handelt sich um einen potentiellen Notfall also:
In case of emergency, take your own pulse first!
2. Hilfe rufen (alleine ist blöd)
🤷♀️ ¿𝘿𝙤́𝙣𝙙𝙚 𝙘𝙤𝙡𝙤𝙘𝙖𝙢𝙤𝙨 𝙡𝙤𝙨 𝙚𝙡𝙚𝙘𝙩𝙧𝙤𝙙𝙤𝙨 𝙚𝙣 𝙡𝙖𝙨 𝙢𝙪𝙟𝙚𝙧𝙚𝙨? ¿𝙀𝙣𝙘𝙞𝙢𝙖 𝙤 𝙙𝙚𝙗𝙖𝙟𝙤 𝙙𝙚 𝙡𝙖 𝙢𝙖𝙢𝙖 𝙞𝙯𝙦𝙪𝙞𝙚𝙧𝙙𝙖?
Te cuento en este hilo 🧵
#urgencias #emergencias #electros #ecg #ekg #FOANed #FOAMed #electrodos #electrodes #woman
Te cuento en este hilo 🧵
#urgencias #emergencias #electros #ecg #ekg #FOANed #FOAMed #electrodos #electrodes #woman
Esta es la eterna pregunta que ya se planteaban en 1954, cuando la Asociación Americana del Corazón, @American_Heart, comenzaba a estandarizar dónde se colocaban los electrodos. (En la foto la publi de 1954. Aunque realmente la primera publicación data de 1938).
@American_Heart Allí determinaron que si hay mamas grandes, se colocan los electrodos debajo de la mama, desplazándola hacia arriba para que el menor tejido mamario posible esté entre el electrodo de exploración y el corazón.
Katastrophaler #Ärztepfusch am Uniklinikum Leipzig: durch bis zu 20 gröbste #Behandlungsfehler beginnend auf ZNA, Gynäkologie(E2.2), onkologischer Ambulanz & schließlich Intensivstation wurde meine Mutter das absichtliche Todesopfer auffälliger Ärzte der Leipziger Uniklinik.
Nach bis zu 20 gröbsten Behandlungsfehlern vorheriger Ambulanzen versuchten die ITS-Ärztinnen Rhea Veelken und Lydia Gaal der Leipziger ITS durch Täuschung über den Hirnschaden meiner Mutter Betreuer & Angehörigen zur Zustimmung zur Abstellung der Lebenserhaltung zu überlisten.
Auffälligerweise hängte sich die Oberärztin Stocker der onkologischen Ambulanz in die Abläufe der ITS rein, stattete eigenmächtig einen Besuch auf der ITS ab. In der Folge dessen wurde auf der ITS eine invasive Koronardiagnostik unterlassen. Stockers Besuch wurde nie dokumentiert
(1/10)
#FOAM #EKG #MedTwitter
bei der interpretation eines EKG gibt es wahrscheinlich soviele meinungen wie kardiologen oder wege zum ziel wie nach rom|merskirchen.
daher empfehle ich meinen SuS immer, sich an der anatomie/physiologie zu orientieren und…
#KeepItSimple
#FOAM #EKG #MedTwitter
bei der interpretation eines EKG gibt es wahrscheinlich soviele meinungen wie kardiologen oder wege zum ziel wie nach rom|merskirchen.
daher empfehle ich meinen SuS immer, sich an der anatomie/physiologie zu orientieren und…
#KeepItSimple
(2/10)
1️⃣ frequenz: sie ist ausdruck der durch elektrische aktivität zustande gekommenen anzahl an herzschlägen pro zeiteinheit (beats per minute). wenn aus jeder elektrischen aktivität eine „mechanische antwort“ erfolgt, sprechen wir von pulsschlag.
1️⃣ frequenz: sie ist ausdruck der durch elektrische aktivität zustande gekommenen anzahl an herzschlägen pro zeiteinheit (beats per minute). wenn aus jeder elektrischen aktivität eine „mechanische antwort“ erfolgt, sprechen wir von pulsschlag.
(3/10)
2️⃣ rhythmus: von einem sinusrhythmus (eigentlich besser sinusknotenrhythmus) sprechen wir, wenn der sinusknoten (SN) als autonomer taktgeber der alleinige „erregungsproduzent“ ist. um dies nachweisen zu können, bedarf es eigentlich drei kriterien:
2️⃣ rhythmus: von einem sinusrhythmus (eigentlich besser sinusknotenrhythmus) sprechen wir, wenn der sinusknoten (SN) als autonomer taktgeber der alleinige „erregungsproduzent“ ist. um dies nachweisen zu können, bedarf es eigentlich drei kriterien:
#POCUS con USPed Latinoamérica🌎
En #SabadosdePOCUS Roberth González Cardiólogo Pediatra de 🇵🇪 nos habló de #Ecocardiografía en el Paciente #Critico en #Pediatria.
¿Quieres saber un poco de qué trato?
Abrimos 🧵 👩⚕️👨⚕️
En #SabadosdePOCUS Roberth González Cardiólogo Pediatra de 🇵🇪 nos habló de #Ecocardiografía en el Paciente #Critico en #Pediatria.
¿Quieres saber un poco de qué trato?
Abrimos 🧵 👩⚕️👨⚕️
Comentarios iniciales #PedsICU:
No vemos internamente la interacción cardiopulmonar. El #POCUS ha cambiado eso.
Dicha interacción regularmente había sido estudiada por separado.
La integración ❤️-🫁Pulmón debe ser siempre en contexto.
🔄🔃
No vemos internamente la interacción cardiopulmonar. El #POCUS ha cambiado eso.
Dicha interacción regularmente había sido estudiada por separado.
La integración ❤️-🫁Pulmón debe ser siempre en contexto.
🔄🔃
Algo que le sirvió mucho al Dr. Roberth: la #Fisiología, su funcionamiento.
Ojo, este dato se ha mencionado mucho en nuestras sesiones. El #POCUS en verdad te ayuda a mejorar tus conocimientos básicos, cuando ves lo que tanto estudiaste.
Ojo, este dato se ha mencionado mucho en nuestras sesiones. El #POCUS en verdad te ayuda a mejorar tus conocimientos básicos, cuando ves lo que tanto estudiaste.
1/ pt presents with sudden onset CP at home. Takes Tylenol and goes back to sleep. Wakes up in the AM with mild CP. Goes to outside hospital with near res of pain. Trop 5 on arrival. No EKG changes. Diag cath 🔽
@HadyLichaaMD @agtruesdell @RajTayalMD @rajivxgulati @DrAmirKaki
@HadyLichaaMD @agtruesdell @RajTayalMD @rajivxgulati @DrAmirKaki
2/ Outside hospital does not do PCI. What would you do next? #Cardiotwitter
@CardioBot @BotPci @BaoGTran @trivaxheartmd @LuaySayed @djc795 @evandrofilhobr @Uqayyum123 @iQ_cath @TheNarulaSeries @nyalborgesmd @ekgpdx @SamChitsaz @cardioPCImom @MarqPatton @mirvatalasnag @hect2701
@CardioBot @BotPci @BaoGTran @trivaxheartmd @LuaySayed @djc795 @evandrofilhobr @Uqayyum123 @iQ_cath @TheNarulaSeries @nyalborgesmd @ekgpdx @SamChitsaz @cardioPCImom @MarqPatton @mirvatalasnag @hect2701
3/ I decided to place on G2B3a and ship to me. Plans for #PCI 12-24 hours after Aggrastat marinate. Patient continues to have mild CP controlled with nitro. #EKG stable. This is image next morning.
@BotPci @yourheartdoc1 @alaa_gabi @doconmoney @AkhilGulati @Pooh_Velagapudi
@BotPci @yourheartdoc1 @alaa_gabi @doconmoney @AkhilGulati @Pooh_Velagapudi
Non-COVID teaching: Can you identify this unusual cause of chronic cough? (Hint: always carefully look at tubes and lines on #CXR and axis on #EKG) #medtwitter #FOAMed #FOAMrad
So let’s jump into this #FOAMed case. On the CXR we’ve got a couple interesting things:
* the PICC line appears to terminate on the wrong (e.g. left) side (white arrow)
* the aortic knob is on the wrong (e.g. right) side (grey arrow)
* it’s hard to identify the cardiac silhouette
* the PICC line appears to terminate on the wrong (e.g. left) side (white arrow)
* the aortic knob is on the wrong (e.g. right) side (grey arrow)
* it’s hard to identify the cardiac silhouette
Some of these findings are easy to miss. To avoid missing things, it’s really important to have a systematic approach to reading a CXR. Here’s a good one:
➡️mededportal.org/doi/10.15766/m…
➡️mededportal.org/doi/10.15766/m…
Abro hilo.
Evitemos malentendidos:
Epidemiología ≠ Infectología ≠ Microbiología.
Epidemiología es el estudio del comportamiento de las enfermedades en la POBLACIÓN. Aplica para TODAS (ej. Epidemiología del #cancer)
Primero necesitas tener diagnóstico objetivo de la enfermedad.
Evitemos malentendidos:
Epidemiología ≠ Infectología ≠ Microbiología.
Epidemiología es el estudio del comportamiento de las enfermedades en la POBLACIÓN. Aplica para TODAS (ej. Epidemiología del #cancer)
Primero necesitas tener diagnóstico objetivo de la enfermedad.
1/x
If you have difficulty interpreting an ECG, I will explain the basic method that I use, and I am sure it will help you. It's called the basic "method of Dr. Roig". Here we go..
If you have difficulty interpreting an ECG, I will explain the basic method that I use, and I am sure it will help you. It's called the basic "method of Dr. Roig". Here we go..
2/x
R-ate
The first step is to calculate the HR.
Total QRS x 6 = HR.
If HR > 100 bpm = Tachycardia.
If HR < 60 bpm = Bradycardia.
R-ate
The first step is to calculate the HR.
Total QRS x 6 = HR.
If HR > 100 bpm = Tachycardia.
If HR < 60 bpm = Bradycardia.
3/x
O-bserve the rhythm
The second step is to observe the rhythm.
If R-R interval is equal = Regular rhythm.
If R-R interval varies = Irregular rhythm.
If P wave is upright in lead II = Sinus rhythm.
O-bserve the rhythm
The second step is to observe the rhythm.
If R-R interval is equal = Regular rhythm.
If R-R interval varies = Irregular rhythm.
If P wave is upright in lead II = Sinus rhythm.
Ok my first crack at this. Tell me what’s going on with this #EKG. 27 yro male, no PMH comes to ER with “weakness”. What to do. #ICUIRL
cc: @EM_RESUS @MDaware @jlitell @cardiojaydoc02 @HeartOTXHeartMD @VenkBellamkonda @ogi_gajic
cc: @EM_RESUS @MDaware @jlitell @cardiojaydoc02 @HeartOTXHeartMD @VenkBellamkonda @ogi_gajic
I added a retweet w/comment with some more pertinent information.
Ok..more data. Initial troponin is 1.6 and and the patient tells you he may have done some partying. Which drug are you concerned about?
Another #12LeadThursday, another EKG puzzle to keep you thinking until the weekend. #cardiotwitter #EKG #ECG #medtwitter
It's #12leadthursday-- time to test those #cardio skills! Look out for answers tonight so you don't miss a beat ☺️ #FOAMed #cardiotwitter
What is the underlying rhythm? See reply for the answer @amalmattu @MasriAhmadMD @MusaSharkawi @jelevenson @ @mbelshazly #FOAMed #EKG
@amalmattu @MasriAhmadMD @MusaSharkawi @jelevenson @mbelshazly A cursory glance may fool one to think this is atrial flutter. On closer inspection clear preceding p-waves are seen. This gentleman has Parkinson's disease and the undulating baseline coincides with his resting tremor frequency.
@amalmattu @MasriAhmadMD @MusaSharkawi @jelevenson @mbelshazly I have seen this almost a dozen times already. I shall dub this Electrical Parkinsonism.
