Ekg files

This is the classic sine wave ECG pattern of severe hyperkalaemia. It can quickly deteriorate into ventricular fibrillation VF.

There are three main ECG changes in hyperkalaemia:. Later changes involve a decrease in height of the p-wave and increase in length of the PR interval as conduction is slowed through the atrial myocardium.

This pattern eventually deteriorates to the sine wave pattern seen above. This is a medical emergency. Inhaled salbutamol has a similar effect if there is no IV access. Bicarbonate 50ml IV can also be given. Ultimately total body potassium needs to be decreased — in this case urgent dialysis or haemofiltration is indicated. Question 12 A 65 year old woman presents with chest pain radiating to her jaw and down her left arm.

There is we assume new t-wave inversion in consecutive leads which fit with an anatomical territory inferolateral and most importantly there is ongoing ischaemic sounding chest pain not eased by GTN. However, note the ST elevation in aVR. As such, this is more suggestive of critical left main stem occlusion. Question 13 A 25 year old man presents with a collapse which occurred as he was playing in a football match.

He has suffered episodes of fainting in the past. These changes represent transmission through an accessory pathway. The history of collapse in this case is concerning as these episodes could be due to re-entrant tachycardias which can be fatal. Other features not seen here which may be present in WPW include a dominant R wave in V1 and T wave inversion in the anterior chest leads.

Question 14 An 18 year old man signs up to join the army. He is fit and well. This is his ECG taken at his medical examination. Is it normal? No it is certainly not normal. This condition has a high risk of sudden death from ventricular fibrillation VF. Treatment is with an implantable cardioverter-defibillator ICD.

Question 15 A 58 year old smoker presents with tight epigastric pain. He looks sweaty and unwell. One of the nurses shows you his routine ECG. This is acute posterior MI. Imagine flipping the ECG paper over and looking at it from behind or looking at the ECG in a mirror held along the inferior border. You would see ST elevation the deep ST depression reversed , t-wave inversion upright t-waves seen upside down and this represents what is going on in the posterior region of the heart.

Question 16 A 29 year old presents with central chest pain. She has a history of recent flu-like illness but no significant past medical history. The diagnosis is pericarditis.

Pericarditis often presents in young people after a history of viral illness. He you can see the characteristic widespread saddle-shaped ST elevation and PR depression.

Question 17 A 70 year old woman presents with sudden onset of chest pain. The pain is crushing in nature and radiates up to her jaw. Question 18 A 45 woman has just stepped off a flight from Japan when she develops severe pleuritic chest pain and shortness of breath. On examination her chest is clear. What is the most likely diagnosis? However, though it may be classical it is extremely rare in clinical practice! Question 19 It is early January and a middle-aged man is found lying in a park.

He is surrounded by bottles of Buckfast and has a GCS of 9. An ECG is performed in the ambulance. This patient is hypothermic. The positive deflection after the QRS but before the t-wave is an Osbourne J-wave; these can also be seen in subarachnoid haemorrhage SAH and hypercalcaemia. Classically a hypothermic patient is bradycardic and their ECG will show J-waves. Treatment in this case would be with gentle rewarming provided there was no immediate risk to life from an arrhythmia. Question 20 A 61 year old woman presents to the emergency department with diarrhoea and vomiting.

She has recently been started on furosemide by her GP for hypertension. What has happened? This ECG shows changes consistent with hypokalaemia. This has likely be precipitated by the new loop diuretic. Note also that furosemide is not a first-line treatment for hypertension. Classically hypokalaemia causes t-wave flattening with ST depression. In severe cases you may see a U-wave. This is a positive deflection following the t-wave but preceding the p-wave. These are found in hypokalaemia but also in hypercalcaemia and thyrotoxicosis.

Question 21 An 18 year old lady is found collapsed at home. When you see her she has a GCS of 10 and you notice that her pupils are dilated.

The diagnosis is tricyclic antidepressant overdose. This causes widening of the QRS complex and lengthening of the QT interval due to blockade of sodium channels. Question 22 A 45 year old man is found collapsed at home. There is no history available. This is a difficult case and shows runs of polymorphic VT or Torsades de pointes literally translated as twisting of the points. It has a number of causes including medications especially psychotropics and electrolyte imbalance.

Essentially any cause of long QT can precipitate polymorphic VT. Management in the first instance is magnesium 2g IV, independent of serum magnesium concentration before treating any other cause of long QT.

Question 23 A 50 year old man presents with collapse. He has been unwell recently with a chest infection for which he has been prescribed clarithromycin from his GP. He also takes medication for his hayfever at this time of year. What is most concerning here? This patient has a prolonged QT interval and a cause for this should be sought. Medications are the likely culprits in this case: both clarithromycin and the antihistamine diphenhydramine can cause prolonged QT interval.

The normal length of the QT varies with heart rate and there is a formula that is applied to correct for this. Normal QTc is generally under ms. Did your computer fail to open an EKG file? We explain what they are used for and recommend software that we know can open or otherwise handle your.

EKG files. The EKG file extension indicates to your device which app can open the file. However, different programs may use the EKG file type for different types of data. While we do not yet describe the EKG file format and its common uses, we do know which programs are known to open these files, as we receive dozens of suggestions from users like yourself every day about specific file types and which programs they use to open them.

We are continually working on adding more file type descriptions to the site, so if you have information about EKG files that you think will help others, please use the Update Info link below to submit it to us - we'd love to hear from you! You will need a program compatible with the specific file you are trying to open, as different programs may use files with file extension EKG for different purposes.

While we have not verified the apps ourselves yet, our users have suggested 3 different EKG openers which you will find listed below. These apps are known to open certain types of EKG files.

Remember, different programs may use EKG files for different purposes, so you may need to try out a few of them to be able to open your specific file.

Try a universal file viewer like Free File Viewer.