yeah that's right.

happy eid to all

this is ur 3eediya

so describe this ECG

Hi all
happy eid ,wish everybody is having a good time,
am still a beginner too in ECG but no harm of trying:
This is wt i think:
there's widened QRS complexes
there's an M pattern most obvious in V5 & Lead 2
i think it's also a left axis deviation
so i think it's left anterior fascicular block
and is this ST depression in lead1 and aVL or wt
if it was then i think it's due to ischemia or angina or also due to LBBB? ?


Thanks for sharing' Hammodi
3od tell us the answer:)

hi safa

u did well, but i think there's no axis deviation, i'd say the axis here is -30 which is borderline (lead 2 is isoelectric so the axis is perpendicular to it). also a hemiblock is combined RBBB and anterior or posterior hemiblock of left bundle branch and here there's no RBBB.

so it's a LBBB because as u mentioned there is wide QRS and "m" shape in V5. thing is there's ST depression as u said and there's also ST elevation in v1 v2 and v3 so how do u explain these ST changes?

Hi again,

may be it's a LBBB associated with acute MI ?
since it's in the anterior directions V1 , V2 & V3 may be anterior MI

but there are Q waves , though i didn't study the part where is it pathological or normal but i remember it's ok to be found in lead 3

In fact , I would appreciate it if somebody explained the pathological Q waves
thanx guyz so much

hi

I'm glad we r discussing ECG in this way

the reason I posted this ECG is to make this point about LBBB and ST elevation, u see, when there is LBBB we can't comment on the ST - T changes, meaning ST elevation becomes insignificant and doesn't mean there is MI, feka mo?

however, put in mind, chest pain plus new LBBB is MI but old LBBB and ST elevation (like in this ECG) is not MI.

so in a patient with LBBB, we only say there is MI or ischemia if there is one of the following:
- ST elevation or depression more than we would expect from LBBB alone (> 1 big square)
- new arrythmia
- ST elevation in same direction as QRS

as for the Q waves Safa, they r normally found in lateral leads and these are V5, V6, lead 1 and aVL. Q waves r pathological if they are 2 mm (2 small squares) deep or more, or if they are 1 mm wide or more

i'm really enjoying ur discussion guys , i hope u keep it on
and although it is ur birthday but u are giving us the present hamoodi,
happy birthday.


ali

thank u ali glad u r enjoying this

This is really "feka"
thnx alot Mohammed
Inshalla always we have such topics