How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

34 results for

Right Ventricular Strain EKG Pattern

by
...
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

1. Right Ventricular Strain EKG Pattern

Right Ventricular Strain EKG Pattern Right Ventricular Strain EKG Pattern Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Right (...) Ventricular Strain EKG Pattern Right Ventricular Strain EKG Pattern Aka: Right Ventricular Strain EKG Pattern , Electrocardiogram in Pulmonary Hypertension , S1-Q3-T3 From Related Chapters II. Diagnostics: Electrocardiogram (EKG) (partial or complete) Inversion Typically in anterior leads (V1-4) May affect inferior leads (II, III, avF) in some cases Prominent s in aVR Associated with worse prognosis in and S1-Q3-T3 Pattern (early left posterior fascicle block) S Wave in lead I Q Wave in lead III inversion

2018 FP Notebook

2. Right Ventricular Strain EKG Pattern

Right Ventricular Strain EKG Pattern Right Ventricular Strain EKG Pattern Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Right (...) Ventricular Strain EKG Pattern Right Ventricular Strain EKG Pattern Aka: Right Ventricular Strain EKG Pattern , Electrocardiogram in Pulmonary Hypertension , S1-Q3-T3 From Related Chapters II. Diagnostics: Electrocardiogram (EKG) (partial or complete) Inversion Typically in anterior leads (V1-4) May affect inferior leads (II, III, avF) in some cases Prominent s in aVR Associated with worse prognosis in and S1-Q3-T3 Pattern (early left posterior fascicle block) S Wave in lead I Q Wave in lead III inversion

2016 FP Notebook

3. Left Ventricular Hypertrophy Related EKG Changes

Probable : 4 points Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Left Ventricular Hypertrophy Related EKG Changes." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Myocardial Disorders About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now (...) Left Ventricular Hypertrophy Related EKG Changes Left Ventricular Hypertrophy Related EKG Changes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer

2018 FP Notebook

4. Chronic Right Ventricular Hypertrophy, or Acute Right Heart Strain? The ECG Helps Make the Diagnosis.

and Eisenmenger's syndrome, complicated by acute heart failure. The ECG was instrumental in differentiating chronic RV hypertrophy from acute right heart strain, and helped guide therapy towards left heart failure (nitroglycerine) which could be dangerous in pulmonary embolism. Posted by Steve Smith at Labels: Reactions: 9 comments: Great case and very informative. Initially looking at the ECG, I immediately thought PE based on the right ventricular strain patterns including RAD, RVH, Incomplete RBBB, S1Q3T3 (...) Chronic Right Ventricular Hypertrophy, or Acute Right Heart Strain? The ECG Helps Make the Diagnosis. Dr. Smith's ECG Blog: Chronic Right Ventricular Hypertrophy, or Acute Right Heart Strain? The ECG Helps Make the Diagnosis. Tuesday, October 2, 2012 A middle-aged, obese, non English speaking man presented as a walk-in with SOB and leg swelling. His O2 saturations were 59% on room air. Systolic BP was in the 170's. He appeared to be mildly dyspneic, in no great distress, and was speaking

2012 Dr Smith's ECG Blog

5. EKG Changes in Syncope due to Arrhythmia

with right ventricular strain pattern (e.g. ) See Inversion in anterior (V1-3) or inferior (II, III, avF) leads Prominent s Pattern (S in I, Q in III, T inversion in III) EKG in Initial: Peaked s in V2-3, II, III Next: ST depression, First degree , shortening Next: with loss of s EKG in Very large amplitude s V. Efficacy EKG is low yield in syncopal patients under age 40 years old (however most warrant EKG in ED evaluation) VI. References Herbert (2014) EM:Rap 14(7): 15-6 Images: Related links (...) to external sites (from Bing) These images are a random sampling from a Bing search on the term "EKG Changes in Syncope due to Arrhythmia." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Syncope (C0039070) Definition (MEDLINEPLUS) Fainting is a temporary loss of consciousness. If you're about to faint, you'll feel dizzy, lightheaded, or nauseous. Your field of vision may "white out" or "black out." Your skin may

2018 FP Notebook

6. Left Ventricular Hypertrophy Related EKG Changes

Probable : 4 points Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Left Ventricular Hypertrophy Related EKG Changes." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Myocardial Disorders About FPnotebook.com is a rapid access, point-of-care medical reference for primary care and emergency clinicians. Started in 1995, this collection now (...) Left Ventricular Hypertrophy Related EKG Changes Left Ventricular Hypertrophy Related EKG Changes Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer

2015 FP Notebook

7. EKG Changes in Syncope due to Arrhythmia

with right ventricular strain pattern (e.g. ) See Inversion in anterior (V1-3) or inferior (II, III, avF) leads Prominent s Pattern (S in I, Q in III, T inversion in III) EKG in Initial: Peaked s in V2-3, II, III Next: ST depression, First degree , shortening Next: with loss of s EKG in Very large amplitude s V. Efficacy EKG is low yield in syncopal patients under age 40 years old (however most warrant EKG in ED evaluation) VI. References Herbert (2014) EM:Rap 14(7): 15-6 Images: Related links (...) to external sites (from Bing) These images are a random sampling from a Bing search on the term "EKG Changes in Syncope due to Arrhythmia." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Syncope (C0039070) Definition (MEDLINEPLUS) Fainting is a temporary loss of consciousness. If you're about to faint, you'll feel dizzy, lightheaded, or nauseous. Your field of vision may "white out" or "black out." Your skin may

2015 FP Notebook

8. Persistent Juvenile T-wave Pattern

revisiting the “true” juvenile T wave pattern. Recall that the RV of the neonate has spent 9 months fighting the high-resistance pulmonary circulation, and so the RV is (non-pathologically) hypertrophied. As a result, there may be ECG findings of right ventricular dominance, including T-wave inversion (TWI) in leads V1-V3 or V4 in young children. Generally, this pattern evolves to the adult pattern (i.e. TWI limited to V1) by about 10 years of age. Characteristics of “true” juvenile T wave pattern (...) pattern. How distinct is this STE/TWI pattern from “true” PJTWP? Is it a minor variant, or is it clinically important? Again, the answer isn’t clear from the recent results. I guess you could say that our case and review suggest that “persistent juvenile” T wave pattern may be neither persistent nor juvenile. References 1. Marcus FI. Prevalence of T-Wave Inversion Beyond V1 in Young Normal Individuals and Usefulness for the Diagnosis of Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia. Am J

2015 Dr Smith's ECG Blog

9. ST Depression and T-wave inversion in V2 and V3.

written records from an outside hospital: EKG read: Normal sinus rhythm Right ventricular hypertrophy with repolarization abnormality Nonspecific T wave abnormality Prolonged QT Abnormal ECG No significant change since 05-17-18 Previous echo Final Impressions: 1. Normal LV size, moderately increased wall thickness, normal global systolic function with an estimated EF of 60 - 65%. 2. Right ventricular cavity size is severely enlarged, global systolic RV function is severely reduced. 3. Severely (...) ST Depression and T-wave inversion in V2 and V3. Dr. Smith's ECG Blog: ST Depression and T-wave inversion in V2 and V3. Tuesday, February 12, 2019 A middle aged male dialysis patient was found disorganized and paranoid. He had no chest pain or dyspnea. An ECG was recorded. The clinician was worried about his ECG and showed it to me: What do you think? When I saw this ECG, I immediately recognized right ventricular hypertrophy as the cause of the ST depression and T-wave inversion in leads V2

2019 Dr Smith's ECG Blog

10. A 30-something woman with chest pain and h/o pulmonary hypertension due to chronic pulmonary emboli

missing here? Also, do we always need the RAD to confirm RVH w/ "strain" or is the strain pattern enough? Thank you Dr. Smith, Octavio Octavio, I wrote that there is NO right axis deviation: "But there is no right axis deviation (axis is however borderline at 83 degrees, nearly vertical " Steve My apologizes! Moreover, I was referring to the 50-something male w/ dyspnea. The Axis for that one is quite vertical as well correct? Thank you for your reply Dr. Smith! I'd like to also respond to Octavio (...) ventricular hypertrophy (RVH). However, most other features of RVH are not present. There is an incomplete RBBB, which does support RVH. But there is no right axis deviation (axis is however borderline at 83 degrees, nearly vertical. There is no large R-wave in V1. However, these findings are not sensitive enough for RVH to rule it out. The T-wave morphology, along with the known history of pulmonary hypertension, should alert you to look for a previous ECG. I saw this and thought immediately

2017 Dr Smith's ECG Blog

11. Thrombolytics for Submassive Pulmonary Embolism

order an EKG, which demonstrates an S1Q3T3 pattern and a troponin level which is very mildly elevated at 0.12. You think to yourself, “I’ve got this diagnosis” and order a PE protocol CT which identifies bilateral acute pulmonary emboli with a significant clot burden as well as dilation of the right ventricle. A bedside cardiac ultrasound was suggestive of right ventricular dilatation, so you send the patient to the Cardiac Diagnostic Lab for a formal ECHO, which reveals a markedly dilated right (...) ventricle with Slattened septal motion, McConnell’s sign of right ventricle apical hyperkinesis, and tricuspid regurgitation consistent with right ventricular dysfunction in the context of an acute pulmonary embolism. Given the relatively young age of the patient and his previously normal cardiac function, you consider whether to offer thrombolytic therapy given the degree of right ventricular dysfunction seen on ECHO. However, the patient has a SBP > 110 and is on room-­‐air, and hence does not meet

2014 Washington University Emergency Medicine Journal Club

12. A young woman with altered mental status and hypotension

, Pendell. thank you. when I first saw the ecg, I wondered if this might be Arrythmogenic right ventricular cardiomyopathy with the deep T waves anteriorly, and what I thought was an epsilon wave in V1. but of course I was wrong. but then I wondered : is the effect similar; i.e., a stressed, "ill" , unhappy right ventricle (stretched, strained , ischemic in the case of a pulmonary embolus. diseased myocardium in the right ventricle in ARVC. and is that why the pattern of the ECG's are similar (...) was delirious, ill-appearing, hypotensive, tachycardic, afebrile, satting 99% on 2L/min masal cannula. Sinus tachycardia Acute RV strain pattern evidenced by the morphology of the QRS and T-wave in V1-V3, including small-moderate R-wave followed by deep S-wave, then concave ST segment into whole T-wave inversion. The fact that lead V3 does not have a deep S-wave like the other examples you will find in the link below is simply due to it being the transition lead in this case, where the QRS progresses from

2019 Dr Smith's ECG Blog

13. A 37 year old woman with Chest Pain

on the tble of a saddle embolus ... ? One of the most common oversights/misinterpretations is to equate anterior T wave inversion = coronary disease/ischemia — when at times this may be a classical picture of acute Right-Heart "Strain". It was exactly what was on the ECG. I think in general a good history, clinical exam, ECG evaluation and probably bedside echo combined should be sufficient to make a good assessment in almost all cases. Thinking back to the case of the pulmonary embolism: a good echo (...) conflict. She had had similar episodes before when angry or stressed." "Her vital signs are BP 110/70, P 70/m, RR 18/m, O2 sat 98% RA. Physical exam was normal." Here is the ECG: What do you think? Here was my response: "I looked at the ECG and immediately thought "This is an acute LAD occlusion." It is diagnostic of LAD occlusion, but really only to someone who has expertise. You will virtually never see an EKG like this that is a patient's baseline. The T-waves are huge in proportion to the QRS

2016 Dr Smith's ECG Blog

14. Family Practice Notebook Updates 2018

, continues to offer better outcomes when core is <28 C or if hemodynamic instability (gi, rad) Several protocols exist for evaluating the with including for free air, and localizing (cv, cad) with mayh be due to right ventricular infarct, , massive , , ventricular rupture (er, neuro) -related delayed CNS bleeding after is uncommon (<2%) and typically does not warrant intervention (er, exam) Consider a brief moment of silence at the end of code in which the patient expired (er, toxin) gas may form (...) , ) Febrile patients are management as and immunocompromised Treat vaso-occlusive crisis aggressively and rapidly and evaluate for other causes if pain pattern is not typical for patient and are medical emergencies (ortho, ob) Symptomatic management includes , PT, , support devices, epidural s Exclude , labor, , (endo, dm, peds) accounts for 1 in 3 diabetes diagnoses in children in the U.S. may present with ketoacidosis as well as positive glutamic acid decarboxylase or islet antigen-2 Screen diabetes

2019 FP Notebook

15. Pulmonary Embolism Diagnosis

air <92% One or more Column B factors over 90 per minute Low grade fever (<101 Fahrenheit) Leg symptoms suggestive of suggestive of Severe PE Criteria Primary Criteria Typical PE Criteria met (see above) or Atypical unexplained , , Additional signs suggestive of severe PE Systolic <90 mmHg above 100 ( ) required >40% FiO2 Signs of new right ventricular strain pattern (EKG) with S1 Q3 T3 pattern EKG with new Atypical PE Criteria Nonspecific cardiopulmonary symptoms Typical criteria not met (see (...) angiography Negative angiography: Evaluate other diagnosis Positive angiography: Treat as Evaluate based on clinical probability IX. Evaluation: Step 6 - Determine Diagnostic Approach in a hemodynamically unstable patient Not critically ill and CT angiography available CT Angiography positive Treat as CT Angiography negative Consider alternative diagnosis Critically ill or CT Angiography not available See with right ventricular dysfunction Treat as without right ventricular dysfunction Consider

2018 FP Notebook

16. Family Practice Notebook Updates 2016

may be seen in EKG as a right heart strain pattern EKG findings include , T inversion in V1-V4, aVR, , , (lung, ) Apply a stepped approach to uncontrolled , stepping up or down therapy every 2-4 weeks until controlled Steps 1-3 advance from prn (SABA), adding low dose , then long-acting (LABA) Steps 4-6 advance from low dose, to moderate and then high dose, as well as allergy management (rheum, pharm) Risk of opportunistic or reactivated infections (e.g. Tb, , , CMV) Risk of (er, manage) Discuss (...) with , or s Invasive management in refractory cases include and left atrial appendage ablation (lung, cv) is idiopathic or genetic, rare and has specific treatments Four secondary types include left heart disease, lung disease, chronic PE or miscellaneous (e.g. sickle cell) is often delayed 4 years or more despite multiple evaluations/ s Consider in progressive on exertion or is the first line diagnostic tool, evaluating pulmonary pressures and right ventricular function Reviewed (cv, ekg, pe) Acute in PE

2018 FP Notebook

17. Electrocardiogram in Myocardial Infarction

-wave inversion Occurs in multiple precordial leads Left main stenosis marker ST Depression >1 mm in 8 or more leads (esp I, II, V4-6) AND in aVR or V1 Suggests multi-vessel ischemia or left main obstruction aVR ST segment elevation > V1 ST segment elevation Biphasic or deep Inversion in V2, V3 ( ) High risk for left anterior descending artery ischemia and Anterior Wall VIII. Findings: General EKG Changes suggestive of acute coronary infarction New left ventricular strain pattern Q Waves (.04 sec (...) with Right Ventricular Infarction XII. Findings: Lateral MI Anatomic Distribution EKG Changes ST segment elevation in leads V5, V6, I, aVL ST segment depression in leads V1, V2, V3, III, aVF (reciprocal change) Distribution Left : Circumflex branch Complications AV nodal block XIII. Findings: Right Ventricular Infarction Anatomic Distribution Standard EKG Changes (similar to anterior MI EKG when rotated 180 degrees) in leads I and aVF, and lead III more than II ST depression in leads I, aVL (reciprocal

2018 FP Notebook

18. Kawasaki Disease

Titer ( ) Sterile pyuria Consider if suspected may be seen in Kawasaki's X. Diagnostics (EKG) May demonstrate strain pattern (ST and changes) Observe for cardiomegaly MRI May be used when is non-diagnostic (esp. circumflex, distal vessels) May demonstrate stenosis, thrombi or intimal hyperplasia XI. Imaging: Echocardiogram Coronary Artery evaluation Initial at presentation Follow-up at 2 weeks and 6-8 weeks Indications for at 6-12 months Abnormalities on prior s AHA guidelines currently recommend (...) in all patients However no benefit if prior s normal Findings changes Acute: Tapering, perivascular brightness, ectasia Late: aneurysm Other variable changes Decreased ventricular function XII. Evaluation Diagnostic criteria met (five days of fever and 4 of the 5 other findings present) Treat as Kawasaki Disease May also treat at 4 days if criteria otherwise met Also see alternative criteria listed above Diagnostic criteria not met (five days of fever with only 2-3 other findings) CRP <3 mg/dl

2018 FP Notebook

19. Pulmonary Hypertension Diagnosis

Hypertension Diagnosis Pulmonary Hypertension Diagnosis Aka: Pulmonary Hypertension Diagnosis From Related Chapters II. Diagnosis: Step 1 Tests (EKG) See Right atrial enlargement Right strain pattern (S1Q3T3) Anterior Inversion (leads V1-4) (abnormal in 90% of ) Primary pulmonary artery dilation Increased distal pulmonary vasculature markings Right atrial and ventricular enlargement Right Interlobar pulmonary diameter >16 mm Hilar to thoracic ratio >0.44 Interpretation: suggested Proceed to Step 2 below (...) III. Diagnosis: Step 2 Tests: (most useful) Early findings Tricuspid regurgitation Peak pulmonary pressure estimated (Bernoulli equation) Mean added to Peak tricuspid jet velocity Systolic pulmonary artery pressure >35 to 40 mmHg consistent with Late findings Right ventricular dilation Displaced interventricular septum Dilated main pulmonary artery Interpretation Precautions Peak pulmonary pressure has poor accuracy and is operator dependent Interpretation is best based on a general gestalt

2018 FP Notebook

20. Pulmonary Hypertension

Also evaluates right ventricular function Right ventricular wall thickening (suspicious if >5mm, RVH if >10mm) Right ventricle pushes into left ventricle on (D Sign) (EKG) See Right strain pattern ( pattern) Inversion V1-V4 in aVR New onset rate control may be challenging in Pulmonary Hypertension and risk decompensation s Evaluate for other Evaluate WHO functional class status Six minute walk test (with oximetry) XV. Evaluation: Screening of high risk groups Protocol Annual Reflex to right heart (...) Hypertension Aka: Pulmonary Hypertension From Related Chapters II. Epidemiology increases with age ( may approach 10-20%) III. Definitions Pulmonary Hypertension Pulmonary artery systolic pressure >30 mmHg Pulmonary artery mean pressure >25 mmHg (by cardiac catheterization) (Previously known as ) Idiopathic Pulmonary Hypertension Secondary Pulmonary Hypertension Secondary to one of Right ventricular failure Secondary to respiratory cause of Pulmonary Hypertension IV. Pathophysiology Pulmonary vascular bed

2018 FP Notebook

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>