Guest guest Posted December 22, 2004 Report Share Posted December 22, 2004 Congratulations! SPAM for all. You both nailed it. Pericarditis. BTW, Hawaii is the home of the champion SPAM eaters in the world. GG > > > OK, I'll also give it a shot. The ST changes in II, III, aVF, I, > V5, V6 aVL all would indicate an inferior wall MI s/ lateral > extension except for the J point notching noted in some of the > leads. This " global presentation " an MI w/ the J notcing is > indicative of pericarditis. The PRI depression in I, II, V4-V6 > should also be noted as it is also associated w/ pericarditis. > > Any reciprocal changes in V1 would be indicative of an posterior MI > probably not percarditis. As far as the aVR changes who needs that > lead. > > My thoughts, (Thanks to Lance Villers) > Mike Shown > > > > > > > Okay Gene, since nobody else is willing to take a stab at this, > I'll bite. > > > > My first thought was an inferolateral infarct due to STE in II, > III, aVF and > > I, V5, V6, aVL. But that pesky little PR segment depression got > me thinking > > otherwise, and after agonizing over it, I can't decide between > STEMI and > > acute pericarditis. The reciprocal changes in V1 and aVR lead me > toward > > pericarditis, even though you would expect to see something in V2- > V4. On > > the other hand, the lack of increased pain during respiration and > the fact > > that you specifically mentioned the absence of a rub means that I > am > > perpetually indecisive. > > > > Rate: ~80 > > Rhythm: sinus > > Axis is normal > > PR: ~20 ms > > QRS: ~10 ms > > QTc: ~0.43 s > > > > On another note, I ordered Tom 's 12 lead book for myself for > > Christmas (yes I know my life is sad... LOL). Perhaps I will be > > enlightened. > > > > Lancaster > > > > > > > > > > > > > > ECG Puzzler > > > > > > Here's a puzzler for you: (Taken from, and thanks to, > www.heartstuff.com. > > This appeared on the ekglist, which I urge all who are called upon > to > > interpret ecgs to join) > > > > You should be able to identify at least 3 significant changes > which will tip > > you off to the patient's condition. Point out at least 7 Hx > findings which > > are significant in this patient. > > > > Hx: Adult female patient with chest pain described as sharp and > > intermittent, not affected by respirations. Has " kept her awake > all night > > last night. " > > Is taking oral contraceptive and has been taking APAP and sudafed > 30 mg bid > > for last week. > > BP 118/74, clear and equal BBS at 20, sat 96, abd soft, non-tender, > > non-distended, +BS, COR RRR, S1 & S2, no murmurs, gallops, or rubs, > BGL 86. > > > > Winner gets a copy of " The Gourmet SPAM Cookbook. " (Trivia > question: > > What > > State consumes the most SPAM?) > > > > Gene Gandy > > > > > > > > > > > > > > > > E.(Gene) Gandy > > POB 1651 > > Albany, TX 76430 > > wegandy1938@a... > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2004 Report Share Posted December 22, 2004 Congratulations! SPAM for all. You both nailed it. Pericarditis. BTW, Hawaii is the home of the champion SPAM eaters in the world. GG > > > OK, I'll also give it a shot. The ST changes in II, III, aVF, I, > V5, V6 aVL all would indicate an inferior wall MI s/ lateral > extension except for the J point notching noted in some of the > leads. This " global presentation " an MI w/ the J notcing is > indicative of pericarditis. The PRI depression in I, II, V4-V6 > should also be noted as it is also associated w/ pericarditis. > > Any reciprocal changes in V1 would be indicative of an posterior MI > probably not percarditis. As far as the aVR changes who needs that > lead. > > My thoughts, (Thanks to Lance Villers) > Mike Shown > > > > > > > Okay Gene, since nobody else is willing to take a stab at this, > I'll bite. > > > > My first thought was an inferolateral infarct due to STE in II, > III, aVF and > > I, V5, V6, aVL. But that pesky little PR segment depression got > me thinking > > otherwise, and after agonizing over it, I can't decide between > STEMI and > > acute pericarditis. The reciprocal changes in V1 and aVR lead me > toward > > pericarditis, even though you would expect to see something in V2- > V4. On > > the other hand, the lack of increased pain during respiration and > the fact > > that you specifically mentioned the absence of a rub means that I > am > > perpetually indecisive. > > > > Rate: ~80 > > Rhythm: sinus > > Axis is normal > > PR: ~20 ms > > QRS: ~10 ms > > QTc: ~0.43 s > > > > On another note, I ordered Tom 's 12 lead book for myself for > > Christmas (yes I know my life is sad... LOL). Perhaps I will be > > enlightened. > > > > Lancaster > > > > > > > > > > > > > > ECG Puzzler > > > > > > Here's a puzzler for you: (Taken from, and thanks to, > www.heartstuff.com. > > This appeared on the ekglist, which I urge all who are called upon > to > > interpret ecgs to join) > > > > You should be able to identify at least 3 significant changes > which will tip > > you off to the patient's condition. Point out at least 7 Hx > findings which > > are significant in this patient. > > > > Hx: Adult female patient with chest pain described as sharp and > > intermittent, not affected by respirations. Has " kept her awake > all night > > last night. " > > Is taking oral contraceptive and has been taking APAP and sudafed > 30 mg bid > > for last week. > > BP 118/74, clear and equal BBS at 20, sat 96, abd soft, non-tender, > > non-distended, +BS, COR RRR, S1 & S2, no murmurs, gallops, or rubs, > BGL 86. > > > > Winner gets a copy of " The Gourmet SPAM Cookbook. " (Trivia > question: > > What > > State consumes the most SPAM?) > > > > Gene Gandy > > > > > > > > > > > > > > > > E.(Gene) Gandy > > POB 1651 > > Albany, TX 76430 > > wegandy1938@a... > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2004 Report Share Posted December 22, 2004 Congratulations! SPAM for all. You both nailed it. Pericarditis. BTW, Hawaii is the home of the champion SPAM eaters in the world. GG > > > OK, I'll also give it a shot. The ST changes in II, III, aVF, I, > V5, V6 aVL all would indicate an inferior wall MI s/ lateral > extension except for the J point notching noted in some of the > leads. This " global presentation " an MI w/ the J notcing is > indicative of pericarditis. The PRI depression in I, II, V4-V6 > should also be noted as it is also associated w/ pericarditis. > > Any reciprocal changes in V1 would be indicative of an posterior MI > probably not percarditis. As far as the aVR changes who needs that > lead. > > My thoughts, (Thanks to Lance Villers) > Mike Shown > > > > > > > Okay Gene, since nobody else is willing to take a stab at this, > I'll bite. > > > > My first thought was an inferolateral infarct due to STE in II, > III, aVF and > > I, V5, V6, aVL. But that pesky little PR segment depression got > me thinking > > otherwise, and after agonizing over it, I can't decide between > STEMI and > > acute pericarditis. The reciprocal changes in V1 and aVR lead me > toward > > pericarditis, even though you would expect to see something in V2- > V4. On > > the other hand, the lack of increased pain during respiration and > the fact > > that you specifically mentioned the absence of a rub means that I > am > > perpetually indecisive. > > > > Rate: ~80 > > Rhythm: sinus > > Axis is normal > > PR: ~20 ms > > QRS: ~10 ms > > QTc: ~0.43 s > > > > On another note, I ordered Tom 's 12 lead book for myself for > > Christmas (yes I know my life is sad... LOL). Perhaps I will be > > enlightened. > > > > Lancaster > > > > > > > > > > > > > > ECG Puzzler > > > > > > Here's a puzzler for you: (Taken from, and thanks to, > www.heartstuff.com. > > This appeared on the ekglist, which I urge all who are called upon > to > > interpret ecgs to join) > > > > You should be able to identify at least 3 significant changes > which will tip > > you off to the patient's condition. Point out at least 7 Hx > findings which > > are significant in this patient. > > > > Hx: Adult female patient with chest pain described as sharp and > > intermittent, not affected by respirations. Has " kept her awake > all night > > last night. " > > Is taking oral contraceptive and has been taking APAP and sudafed > 30 mg bid > > for last week. > > BP 118/74, clear and equal BBS at 20, sat 96, abd soft, non-tender, > > non-distended, +BS, COR RRR, S1 & S2, no murmurs, gallops, or rubs, > BGL 86. > > > > Winner gets a copy of " The Gourmet SPAM Cookbook. " (Trivia > question: > > What > > State consumes the most SPAM?) > > > > Gene Gandy > > > > > > > > > > > > > > > > E.(Gene) Gandy > > POB 1651 > > Albany, TX 76430 > > wegandy1938@a... > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 22, 2004 Report Share Posted December 22, 2004 Actually, I kinda like it. Slice it thin and fry it. Makes a hellofa sandwich. In a message dated 12/22/04 5:15:09 PM Central Standard Time, wegandy1938@... writes: > BTW, Hawaii is the home of the champion SPAM eaters in the world. Quote Link to comment Share on other sites More sharing options...
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