ecg left-posterior-fascicular-block 
Dr. Smith's ECG Blog
MARCH 22, 2024
His ECG is shown: What do you think? The history thus far is highly suggestive of OMI, so we must study the ECG very closely to see if we can confirm this. The Queen of Hearts does not care about rhythm analysis, she simply looks at the ECG and decides whether it represents OMI or not. Due to the precordial swirl Dr.
Dr. Smith's ECG Blog
MAY 3, 2024
There were 2 prehospital ECGs: What do you think? There is "shark fin" in I and aVL, which is due to a combination of a large R-wave due to left anterior fascicular block plus downsloping ST elevation due to OMI. Moreover, left main occlusion often presents near death. Posterior and high lateral OMI.
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Dr. Smith's ECG Blog
JUNE 23, 2023
Here is the ED ECG: What do you think? Thus, it is probably SVT with aberrancy (RBBB + LAFB) or it is posterior fascicular VT (which starts in the posterior fascicle and therefore also has a fast initial depolarization nearly identical to RBBB + LAFB). Analysis: there is a wide complex tachycardia. It is regular.
Dr. Smith's ECG Blog
JULY 3, 2020
This ECG was done in a middle aged woman who was in a motor vehicle collision in which her vehicle "T-boned" another, so there was trauma to the anterior chest. ng/mL, and an ECG was recorded: There are no P-waves visible. --Sinoventricular rhythm RBBB and LAFB morphology. The estimated left ventricular ejection fraction is 76 %.
Dr. Smith's ECG Blog
SEPTEMBER 7, 2020
The Differential Diagnosis is: SVT with aberrancy(#) [AVNRT vs. WPW (also called AVRT*)] Atrial flutter with 1:1 conduction, with aberrancy VT coming from the anterior fascicle ( fascicular VT )@ *AVRT = AV Reciprocating Tachycardia (Tachycardic loop that uses both the AV node and an accessory pathway. This confirms SVT, either AVNRT or WPW.
Dr. Smith's ECG Blog
AUGUST 9, 2019
Post by Smith and Meyers Sam Ghali ( [link] ) just asked me (Smith): "Steve, do left main coronary artery *occlusions* (actual ones with transmural ischemia) have ST Depression or ST Elevation in aVR?" The pattern seen may, or may not, be unique to left main occlusion. All are, however, clearly massive STEMI.
Dr. Smith's ECG Blog
NOVEMBER 9, 2012
On arrival, here is his initial ED ECG, and is identical to the prehospital ECG and at the same rate: There is a regular, wide complex. The wide complex has a right bundle branch and left anterior fascicular block morphology. Alternatively, it could be posterior fascicular ventricular tachycardia.
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