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Understanding the Electrocardiogram

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  2. Understanding the Electrocardiogram In Health & Disease
  3. 6.0.0 Ischemia and Infarction - Introduction (frame i and ii)
  4. 6.1.0 ST Segment (frame1)
  5. 6.1.30 (frame 30)

6.1.37 (THIS IS A NEW FRAME)

THIS IS A NEW FRAME AND WILL REQUIRE A NEW GRAPHIC SHOWING THE 6 frontal plane LEADS (I-aVF) FROM FRAME 35 WITH LEADS I, II, III SEPARATED from LEADS aVR,L and F BY THE FRONTAL PLANE TRIAXIAL DISPLAY SHOWING THE ST SEGMENT VECTOR POINTING TO THE RIGHT AND INFERIORLY]

As discussed earlier in another patient with an inferior wall infarction (see page 8), there are additional clues in the standard 12 lead tracing suggesting the possibility of right ventricular involvement. This is the same tracing as that shown on the previous page. The greater ST segment elevation in lead III (4mm) than in lead II (2mm), coupled with the ST depression in leads I and aVL, indicates that the ST segment spatial vector is directed to the right as well as inferiorly. Its frontal plane axis is approximately +120 degrees. This suggests occlusion of the right rather than the circumflex coronary artery and raises the possibility of right sided involvement in the ischemia process.

Book traversal links for 6.1.37 (THIS IS A NEW FRAME)

  • 6.1.36 (36)
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  • 6.1.38 (37)

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Book navigation

  • Introduction to First Edition
  • 1.0.0 Generation of the ECG
  • 2.0.0 The Normal Electrocardiogram
  • 3.0.0 Inter and intra-ventricular Conduction Disturbances
  • 4.0.0 Ventricular Hypertrophy
  • 5.0.0 ELECTROLYTE ABNORMALITIES, DRUG EFFECTS AND THE LONG QT SYNDROMES
  • 6.0.0 Ischemia and Infarction - Introduction (frame i and ii)
    • 6.1.0 ST Segment (frame1)
      • 6.1.1 (2)
      • 6.1.2(3)
      • 6.1.3(4)
      • 6.1.4(5)
      • 6.1.5(6)
      • 6.1.6 (7)
      • 6.1.7 (8)
      • 6.1.8 (new frame)
      • 6.1.9 (9)
      • 6.1.10 (frame 10)
      • 6.1.20 (frame 20)
      • 6.1.30 (frame 30)
        • 6.1.31 (31)
        • 6.1.32 (32)
        • 6.1.33(33)
        • 6.1.34 (34)
        • 6.1.35 (35)
        • 6.1.36 (36)
        • 6.1.37 (THIS IS A NEW FRAME)
        • 6.1.38 (37)
        • 6.1.39 (38)
      • 6.1.40 (frame 39)
      • 6.1.50 (49)
    • 6.2.0 Q WAVES (frame 53)
    • 6.3.0 T WAVES (frame 75)
    • 6.4.0 (Bundle Branch Blocks and othe IVCDs--frame 87)
    • 6.5.0 (frame 106) FALSE POSITIVES
  • 7.0.0 Tachycardias- Introduction
  • 8.0.0 The Bradycardias frame i-introduction
  • 9.0.0 The ECG of Heart Murmurs-introduction
  • 10.0.0 The Electrocardiogram in the Emergency Department-Introduction
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