Thank you for making these videos. They are very helpful. Talk about "light a thousand candles", just imagine how many patients you can help by educating clinical staff. Derek - RN
love that you keep making EKG videos ! Recently presented your explanation for right and left BBB morphology at Walter Reed Internal Medicine residency program. I always make sure to give your channel a shout out
Dude was an EKG teaching legend when he was at Stanford. Supposedly he'd come in at 6am just to do crack-of-dawn EKG office hours with unusually motivated students and housestaff. (I say "supposedly" because I was always still sleeping and couldn't confirm...)
Just to be sure, you mispoke at 22:12 when you said that Papillary Muscle VT displayed inferior axis, right? Because I thought that inferior axis meant positive R waves in the inferior leads, whereas the ones shown seem to be negative. Going back, you also said that posteromedial papillary muscle VT's should have superior axis. Just checking. Thanks for all the work you put into this series!
Sir i am a real fan of your lectures ❤️❤️....pls keep uploading such informative videos....sir can you uplaod more videos on emergency medicine and toxicology topics??
Thanks for the incredible video especially localisation of VT (in fact, I searched online on this but mostly I got nothing or too much that mandates further EP knowledge. Also, textbooks weren't good with this either ). I once read in one book of K Wang that bidirectional VT in the context of digoxin toxicity is mostly not true VT, it's likely a junctional tachycardia that alternates RBB & LBB in a bigeminal fashion. Also, I once tried to get full tracings of pleomorphic VT but they are rare on Google, could you please tell me where you got this tracing from? Any other VT videos, more detailed SVT videos ? Thanks
Re: bidirectional VT, in Wang's Atlas of Electrocardiography (IMHO, an underrated advanced ECG text), he discusses SVT with alternating bundle branch block as one mechanism for bidirectional VT - in which case, calling it VT is obviously a misnomer. In order for this to be the mechanism however, the alternating morphologies need to be consistent with a RBBB and LBBB. That is consistent with the example he uses in his book, but historically, the most commonly described form is a consistent RBBB with alternating right and left axis. I suppose this could be SVT with alternating bifascicular blocks (which also wouldn't be a true VT) but I haven't seen anyone frame it specifically as that. Agree that ECGs of pleomorphic VT are hard to track down! I honestly don't remember where this specific example came from, and unfortunately I don't have an accompanying "original" image file for it. (All of my ECG images have been "remastered" to give them a higher resolution and standardized appearance). I've been working on a video about the differentiation between VT and SVT with aberrancy that hopefully will get posted in the next 2-3 weeks. A deep dive on differentiating all of the different SVTs from one another is also on my to-do list for this series, but that's much further off - many other non-ECG topics to cover too! Thanks for watching!
HI, love your videos first of all!! Second, at first example, 14:26, you mentioned that the inferior leads were upright meaning an inferior axis location however, earlier in the video you mentioned that the upright inferior leads suggest Anterior and downward suggests inferior. Can you clarify?
I think you are confusing axis with location. upright strokes in inferior leads means inferior axis ( the direction of current vector) , that is originating from anterior location in heart ( not inferior location).
@@namphan6911 it can be human error, as it's definitely superior axis originating from relatively inferior/posterior location as stated correctly in previous slide.
I was under the impression "slow vt"= accelerated idoventricular rhythm (AIVR) (also sometimes just called accelerated ventricular rhythm) and is 50-100bpm. The ekg you showed for slow vt would just be vtach as its over 100 and meets all the other criteria. The second ekg you said was AIVR is what's referred to as slow vt sometimes, and I agree with. Is that correct?
Non-pitting edema is just a physical finding that is most often caused by lymphedema, which is a manifestation of the actual disease process. In other words, lymphedema causes non-pitting edema, but not all non-pitting edema is caused by lymphedema. And when lymphedema is present, it is almost always caused by another disease, or is a complication of surgery/radiation therapy.
Mister Erik, you are the best teacher all over the world !!! Thank you so much !
Amazingly well-made video. I'm no EP, just your local street medic, but this was super easy to follow.
Very few comments for such interesting video! Thank you for the very clear and logically structured material.
Thank you for making these videos. They are very helpful. Talk about "light a thousand candles", just imagine how many patients you can help by educating clinical staff. Derek - RN
love that you keep making EKG videos ! Recently presented your explanation for right and left BBB morphology at Walter Reed Internal Medicine residency program. I always make sure to give your channel a shout out
Thanks! Speaking of EKGs and Walter Reed, does John (Eddie) Atwood still practice/teach there?
@@StrongMed Yes! He's awesome, I've worked with him a number of times. Always see him running into work
Dude was an EKG teaching legend when he was at Stanford. Supposedly he'd come in at 6am just to do crack-of-dawn EKG office hours with unusually motivated students and housestaff. (I say "supposedly" because I was always still sleeping and couldn't confirm...)
@@StrongMed I swear he still does this, i've attended a bunch of them
@@StrongMed do you have membership ? do u recomemd any membership?
I enjoy very much cardiology so your videos are my "go to" for the ! Thank again for taking the time to explain ECGs!
Love your explanations. Good summary of VT
Doing a great job Dr Strong as always but i confess EKG is never an easy digestible topic to me
you are always an extraordinary teacher
Just to be sure, you mispoke at 22:12 when you said that Papillary Muscle VT displayed inferior axis, right? Because I thought that inferior axis meant positive R waves in the inferior leads, whereas the ones shown seem to be negative. Going back, you also said that posteromedial papillary muscle VT's should have superior axis. Just checking. Thanks for all the work you put into this series!
Yeah, I thought it should be superior axis, too.
Thanks , you have such an exceptional knack to simplify an clarify complex topics, keep up the good job!!!@
Very nice...easy way to interpretation of VT..thank you so much sir🙏🏻
Excellent work! Congratulations!
what a fantastic video - thank you so much for everything
Excellent!
Nice work
Nice informative video🎉
That was amazing! Thank YOU!
Sir i am a real fan of your lectures ❤️❤️....pls keep uploading such informative videos....sir can you uplaod more videos on emergency medicine and toxicology topics??
Started working on a video yesterday on BRASH syndrome, which sort of hits both of those.
Which college of india ?
ممتاز جدا شكرا
Informative👍
Informed
Thanks for the incredible video especially localisation of VT (in fact, I searched online on this but mostly I got nothing or too much that mandates further EP knowledge. Also, textbooks weren't good with this either ). I once read in one book of K Wang that bidirectional VT in the context of digoxin toxicity is mostly not true VT, it's likely a junctional tachycardia that alternates RBB & LBB in a bigeminal fashion. Also, I once tried to get full tracings of pleomorphic VT but they are rare on Google, could you please tell me where you got this tracing from? Any other VT videos, more detailed SVT videos ? Thanks
Re: bidirectional VT, in Wang's Atlas of Electrocardiography (IMHO, an underrated advanced ECG text), he discusses SVT with alternating bundle branch block as one mechanism for bidirectional VT - in which case, calling it VT is obviously a misnomer. In order for this to be the mechanism however, the alternating morphologies need to be consistent with a RBBB and LBBB. That is consistent with the example he uses in his book, but historically, the most commonly described form is a consistent RBBB with alternating right and left axis. I suppose this could be SVT with alternating bifascicular blocks (which also wouldn't be a true VT) but I haven't seen anyone frame it specifically as that.
Agree that ECGs of pleomorphic VT are hard to track down! I honestly don't remember where this specific example came from, and unfortunately I don't have an accompanying "original" image file for it. (All of my ECG images have been "remastered" to give them a higher resolution and standardized appearance).
I've been working on a video about the differentiation between VT and SVT with aberrancy that hopefully will get posted in the next 2-3 weeks. A deep dive on differentiating all of the different SVTs from one another is also on my to-do list for this series, but that's much further off - many other non-ECG topics to cover too!
Thanks for watching!
@@StrongMed Thank you
HI, love your videos first of all!! Second, at first example, 14:26, you mentioned that the inferior leads were upright meaning an inferior axis location however, earlier in the video you mentioned that the upright inferior leads suggest Anterior and downward suggests inferior. Can you clarify?
I think you are confusing axis with location. upright strokes in inferior leads means inferior axis ( the direction of current vector) , that is originating from anterior location in heart ( not inferior location).
@@Rupeshkumar-lf5rw Can you help me explain why at 22:15 he said it's inferior axis? Because the inferior leads have upright strokes there.
@@namphan6911 it can be human error, as it's definitely superior axis originating from relatively inferior/posterior location as stated correctly in previous slide.
@@Rupeshkumar-lf5rw Thank you. That really helps clear things up for me.
@@namphan6911 sure mate
I was under the impression "slow vt"= accelerated idoventricular rhythm (AIVR) (also sometimes just called accelerated ventricular rhythm) and is 50-100bpm. The ekg you showed for slow vt would just be vtach as its over 100 and meets all the other criteria. The second ekg you said was AIVR is what's referred to as slow vt sometimes, and I agree with. Is that correct?
very nice
Do you mean superior axis at 22:13 ?
I have the same question
Thanks. It was excellent
22:18 - superior axis would be right...
Is non pitting edema and lymphatic edema same disease?
Non-pitting edema is just a physical finding that is most often caused by lymphedema, which is a manifestation of the actual disease process. In other words, lymphedema causes non-pitting edema, but not all non-pitting edema is caused by lymphedema. And when lymphedema is present, it is almost always caused by another disease, or is a complication of surgery/radiation therapy.
@@StrongMed you explained very well. This cleared up my confusion.
Thanks a lot!
good review
Anyone here after Jason Ryan recommended