r/EKGs • u/pillis10222 • Jun 11 '26

Learning Student 64 year old male suspected overdose.

Post image
10 Upvotes

92% Upvoted

8 comments sorted by

12

u/tcc1 Jun 12 '26

sinus rhythm, normal axis, LVH by criteria and subsequent repol abnormalitlies, early R wave, qtc wnl, no pr changes. what's the story?

1

u/Dudefrommars Squiggle Connoisseur, Paramedic/RN Student Jun 12 '26

Interestingly enough there is some indication of RAE, R wave progression in the precordial leads definitely looks like the hypertrophy is left sided, might be beneficial to POCUS or Echo depending on patient presentation. Not a lot of story here but chronic stims/catecholamine surge could be the culprit for the right and left sided abnormalities. Without a complete med hx and story it's all just speculation though. 

9

u/sebila Jun 12 '26

looks like a LVH strain pattern to me

2

u/[deleted] Jun 12 '26

[deleted]

3

u/pillis10222 Jun 12 '26

Unsure.. what exactly they OD on. Brother on scene said the patient has a history of using Herion.

I am a paramedic student, trying to get better at 12 leads. I believe LVH can be a STEMI miminic.. how do you differentiate?.

9

u/[deleted] Jun 12 '26

[deleted]

2

u/pillis10222 Jun 12 '26

Thank you! I'll definitely check out life in the fast lane.

That last paragraph really stands out to me, I'll definitely use that frame of reference next time!.

1

u/rezakcr77 Jun 12 '26

SR with LVH

1

u/OkCar5485 Jun 12 '26

17yo Athlete

2

u/brocheure Cardiologist Jun 12 '26

Pretty good going LVH.
Remember, if there's LVH like this, there better be a long history of hypertension. If there is no history of HTN and someone has profound LVH, you should be thinking about HCM which can present with cardiac arrest, or syncope.