Name:
ECG: Ischemia
Description:
ECG: Ischemia
Thumbnail URL:
https://cadmoremediastorage.blob.core.windows.net/67ec445c-9cad-4ba7-bd19-17d20f26b540/thumbnails/67ec445c-9cad-4ba7-bd19-17d20f26b540.PNG?sv=2019-02-02&sr=c&sig=%2BvB8JWFLmvtzxmU1B8XAdZ0ec7pgrlQVywrrLdjvZ5U%3D&st=2023-03-24T00%3A11%3A12Z&se=2023-03-24T04%3A16%3A12Z&sp=r
Duration:
T00H05M40S
Embed URL:
https://stream.cadmore.media/player/67ec445c-9cad-4ba7-bd19-17d20f26b540
Content URL:
https://asa1cadmoremedia.blob.core.windows.net/asset-d1e49345-59fe-4ec7-b702-dd8a5dac33ca/Ischemia-1.m4v
Upload Date:
2022-03-03T00:00:00.0000000
Transcript:
Language: EN.
Segment:0 .
♪ MUSIC: ♪
Segment:1 Introduction.
♪ MUSIC: EKGs can be very useful in helping us identify ischemia. One sign of ischemia on EKGs is the presence of T-wave inversions.
Segment:2 Normal ECG.
♪ MUSIC: In a normal EKG, the T waves are upright in most leads. When the T waves invert, that can be a sign of ischemia.
♪ MUSIC: Let's take a look at this EKG. Let's start in the inferior wall. To look at the inferior wall, we look at leads 2, 3, and aVF. Let's name the waves. First, we have a P wave, followed by an R wave, followed by an S wave, followed by the ST segment, followed by an inverted T wave.
Segment:3 Inferior wall ischemia.
♪ MUSIC: Now, let's look at the other inferior leads. In lead 3 we also have an inverted T wave, as well as in lead aVF. So, we have T-wave inversions in leads 2, 3 and aVF. This represents inferior wall ischemia.
Segment:4 Lateral wall ischemia.
♪ MUSIC: Let's take a look at another example. On this EKG we see T-wave inversions in leads V5, V6, 1, and aVL.
♪ MUSIC: This reflects lateral wall ischemia.
Segment:5 Inferolateral wall ischemia.
♪ MUSIC: Here's another example. In this case, there are T-wave inversions in leads 2, 3, and aVF, as well as leads V5, and V6. This represents ischemia in both the inferior wall and the lateral wall.
♪ MUSIC: This is called inferolateral ischemia.
Segment:6 Anterolateral wall ischemia.
♪ MUSIC: One more example. What do you see on this EKG? Here, we have T-wave inversions in leads V1, V2, and V3. This is anteroseptal ischemia. Final example.
♪ MUSIC: What do you see here? The underlying rhythm happens to be AFib, but this EKG shows T-wave inversions in leads V1 through V6, as well as 1 and aVL. This is called anterolateral ischemia.
Segment:7 T wave inversions not always abnormal.
♪ MUSIC: A couple of caveats to be aware of. T-wave inversions are not always abnormal. The first caveat is there are some leads where it is normal to have T-wave inversions.
♪ MUSIC: Those leads are leads 3, aVR and V1. So even though there are T-wave inversions in these leads, this is not a sign of ischemia, and this is a normal EKG. Another caveat is that T-wave inversions are not very specific. They can be seen in several other disease processes, including pulmonary embolism and subarachnoid hemorrhage.
Segment:8 Pediatrics.
♪ MUSIC: The last caveat is pediatrics. In children from age seven days until adolescence, it is normal to have T-wave inversions in the right precordial leads, leads V1 through V3. This is called a juvenile T-wave pattern. In fact, if the T waves are upright it could be abnormal, and may be a sign of right-ventricular hypertrophy. This EKG is from a six-year old who complained of palpitations when taking a test in school.
♪ MUSIC: The EKG shows T-wave inversions in leads V1 through V3. However, this is a normal finding in a six year old, and this is a normal EKG. The girl was absolutely fine. She was just a little nervous about a test.
Segment:9 Summary.
♪ MUSIC: So, in summary, T-wave inversions can be a sign of ischemia if they follow a pattern conforming to a specific wall of the heart.
♪ MUSIC: It is normal to have T-wave inversions in leads 3, aVR and V1, and T-wave inversions are also normal in children.
♪ MUSIC: ♪
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