Emergency notes🫀

هسة نجي نشرح عن كل شغلة انذكرت بهذا الكيس حتة متصير هوسة .. bifascicular block presents with one of two ECG patterns: • Right bundle branch block (RBBB) with left anterior fascicular block (LAFB), >>>>manifested as left axis deviation (LAD) • RBBB and left posterior fascicular block (LPFB), >>>>manifested as right axis deviation (RAD) in the absence of other causes

ملخص الحجي التشخيص كالاتي : Sinus tachycardia with Bifasicular BBB ..

‎..مساء الخير.. ‎بالنسبة لهذا الكيس Regular 150 beats/min left axis deviation ‎ svt or sinus tachycardia ؟ طبعاً اكو sign اسمها camel hump sign 🐫 , الي هي تصير من تلتقي الT and P waves والريت كلش عالي بحالات الsinus tachycardia وهاي الساين مرات اتضيع وتكون صعبة انو تنكشف مثل هذا الكيس ☝️☝️ويتعالج المريض ك SVT اما بالنسبة للQRS فصاير بيهة widening ب V1-3 ، وال S صايرة slurred بV5,V6 وهذا يمشي وية RBBB وايضا ال S صايرة deep بالانفيرير ليدز وعدنا ال R طويلة بالAVL,Lead 1 وهذا يمشي وية وية شي اسمة left fasicualr bandle branch block .. اما اذا التقوا الright bundle branch block وية ال left fasicular block فهنا يسموا Bifasicular block

Palpitations Dx?

طبعًا بالsulci لازم موجود csf ويطلع باللون الاسود hypodens هذا النورمال (صورة) اما بصورة ٢ فصاير ابيض hyper dens فهذا يعني SAH

Old age male with headache Dx?

In patients presenting with chest pain, inverted U waves: • Are a very specific sign of myocardial ischaemia • May be the earliest marker of unstable angina and evolving myocardial infarction • Have been shown to predict a ≥ 75% stenosis of the LAD / LMCA and the presence of left ventricular dysfunction

22 yo woman studying for finals having intermittent palpitations → [dx?]  → [next best step]

كيس ischmic stroke الضغط ١٨/٩ ، اكو هستري مال AF مياخذلة علاج .. بالECG طلع هذا الرثم .. صراحة كيس صعبة واني نزلتهة حتة نتناقش وطبعًا ببالي فد تشخيص بس خل نشوف رأيكم 🔥🔥🔥

طبعًا المريض جانوا امشيلة adenosine والسيينير معتبرة SVT .. ECG findings: Regular 150 beats and “Saw-tooth” pattern of inverted flutter waves in leads II, III, aVF فالجواب هو Atrial flutter طبعًا اكو خطأ دا يصير انو البعض عبالهم ال Saw-tooth تبين بكل الليدات وهذا خطأ هي فقط تبين بالانفيرير ليد و V1 … طبعًا يعالج ك AF نقاط مهمة عن Aterial flutter:: ECG features of atrial flutter:: • Narrow complex tachycardia • Regular atrial activity at ~300 bpm • “Saw-tooth” pattern of inverted flutter waves in leads II, III, aVF • Upright flutter waves in V1 that may resemble P waves • Ventricular rate depends on AV conduction ratio (see below) Fixed AV conduction ratio (“AV block”): • 2:1 block = 150 bpm • 3:1 block = 100 bpm • 4:1 block = 75 bpm Variable AV conduction ratio:: • The ventricular response is irregular and may mimic (AF) • On closer inspection, there may be a pattern of alternating 2:1, 3:1 and 4:1 conduction ratios Classification: Typical atrial flutter (common) Anticlockwise Reentry: Commonest form of atrial flutter (90% of cases). Retrograde atrial conduction produces: • Inverted flutter waves in leads II,III, aVF • Positive flutter waves in V1 — may resemble upright P waves Clockwise Reentry: This uncommon variant produces the opposite pattern: • Positive flutter waves in leads II, III, aVF • Broad, inverted flutter waves in V1

طبعًا المريض جانوا امشيلة adenosine والسيينير معتبرة SVT .. ECG findings: Regular 150 beats and “Saw-tooth” pattern of inverted flutter waves in leads II, III, aVF فالجواب هو Atrial flutter طبعًا اكو خطأ دا يصير انو البعض عبالهم ال Saw-tooth تبين بكل الليدات وهذا خطأ هي فقط تبين بالانفيرير ليد و V1 … طبعًا يعالج ك AF نقاط مهمة عن Aterial flutter:: ECG features of atrial flutter:: • Narrow complex tachycardia • Regular atrial activity at ~300 bpm • “Saw-tooth” pattern of inverted flutter waves in leads II, III, aVF • Upright flutter waves in V1 that may resemble P waves • Ventricular rate depends on AV conduction ratio (see below) Fixed AV conduction ratio (“AV block”): • 2:1 block = 150 bpm • 3:1 block = 100 bpm • 4:1 block = 75 bpm Variable AV conduction ratio:: • The ventricular response is irregular and may mimic (AF) • On closer inspection, there may be a pattern of alternating 2:1, 3:1 and 4:1 conduction ratios Classification: Typical atrial flutter (common) Anticlockwise Reentry: Commonest form of atrial flutter (90% of cases). Retrograde atrial conduction produces: • Inverted flutter waves in leads II,III, aVF • Positive flutter waves in V1 — may resemble upright P waves Clockwise Reentry: This uncommon variant produces the opposite pattern: • Positive flutter waves in leads II, III, aVF • Broad, inverted flutter waves in V1

طبعًا المريض جانوا امشيلة adenosine والسيينير معتبرة SVT .. ECG findings: Regular 150 beats and “Saw-tooth” pattern of inverted flutter waves in leads II, III, aVF فالجواب هو Atrial flutter طبعًا اكو خطأ دا يصير انو البعض عبالهم ال Saw-tooth تبين بكل الليدات وهذا خطأ هي فقط تبين بالانفيرير ليد و V1 … طبعًا يعالج ك AF نقاط مهمة عن Aterial flutter:: ECG features of atrial flutter:: • Narrow complex tachycardia • Regular atrial activity at ~300 bpm • “Saw-tooth” pattern of inverted flutter waves in leads II, III, aVF • Upright flutter waves in V1 that may resemble P waves • Ventricular rate depends on AV conduction ratio (see below) Fixed AV conduction ratio (“AV block”): • 2:1 block = 150 bpm • 3:1 block = 100 bpm • 4:1 block = 75 bpm Variable AV conduction ratio:: • The ventricular response is irregular and may mimic atrial fibrillation (AF) • On closer inspection, there may be a pattern of alternating 2:1, 3:1 and 4:1 conduction ratios Classification: Typical atrial flutter (common) Anticlockwise Reentry: Commonest form of atrial flutter (90% of cases). Retrograde atrial conduction produces: • Inverted flutter waves in leads II,III, aVF • Positive flutter waves in V1 — may resemble upright P waves Clockwise Reentry: This uncommon variant produces the opposite pattern: • Positive flutter waves in leads II, III, aVF • Broad, inverted flutter waves in V1