EKG... Inverted R wave

[azz kikr]

In my Exercise Phys. class today we took all our ekg's and everyone had a normal reading where the R wave took a spike upwards but mine took a spike downwards
now i dont know what this means and neither did my professor. Do yall now what may cause this??
My prossefor suggest my heart was angled the opposite way but didnt say for sure. so maybe one who knows about reading ekg's could help out.

 

[bellicose]

Simply means that the axis is different that everyone else in your class. Or the sum negative electric activity is going in a different direction.
Probably just the heart sitting at a different angle, most likely from displacement from other organs. no worries

 

[Nssca]

Muscle fires off... then depolarizes... then over polarizes slightly before reaching the normal resting charged state before being able to contract again.
An ECG reading where the points are "twisted" as in your case is termed as "Torsades de Pointes" a French term meaning twisted points. May be caused by: Hypomagnesemia or by antiarrhythmic drugs.
Id get a Magnesium supp and get checked out by your family doctor.
Common conditions such as mitral valve prolapse, migraines, attention deficit disorder, fibromyalgia, asthma and allergies have all been linked to a Mg deficiency.

 

[Medic08]

Muscle fires off... then depolarizes... then over polarizes slightly before reaching the normal resting charged state before being able to contract again.
An ECG reading where the points are "twisted" as in your case is termed as "Torsades de Pointes" a French term meaning twisted points. May be caused by: Hypomagnesemia or by antiarrhythmic drugs.
Id get a Magnesium supp and get checked out by your family doctor.
Common conditions such as mitral valve prolapse, migraines, attention deficit disorder, fibromyalgia, asthma and allergies have all been linked to a Mg deficiency.

Bro I'm sorry but you shouldn't be giving advice if you don't know what your talking about. Torsades is a deadly rhythm and has nothing to do with an inverted R wave. The above poster is correct when Saying that the axis is different. I've seen torsades only two times in my career as a paramedic so far and they were both cardiac arrest. Torsades is polymorphic vtach.

 

[doctor24]

I am amazed at the willingness to give worthless and dangerous advice! If this EKG was properly done, you may have some serious things to discuss with a cardiologist with a depressed or reversed R wave. A quick review of basic electrocardiography will explain this. Have the test repeated by someone who can perform it and then have it reviewed by a professional. Wow.

Dr 24

 

[maldorf]

Simply means that the axis is different that everyone else in your class. Or the sum negative electric activity is going in a different direction.
Probably just the heart sitting at a different angle, most likely from displacement from other organs. no worries

Im pretty sure this can be alleviated by switching around the leads? I took a class on this in grad school a long time ago and remember something about that. Swapping positions of the leads to the right arm and left leg may be necessary. That would flip it over?

 

[Nssca]

Bro I'm sorry but you shouldn't be giving advice if you don't know what your talking about. Torsades is a deadly rhythm and has nothing to do with an inverted R wave. The above poster is correct when Saying that the axis is different. I've seen torsades only two times in my career as a paramedic so far and they were both cardiac arrest. Torsades is polymorphic vtach.

Look it up its easy enough for even a paramedic to find. Taking a ekg from someone other than a trained medical provider was his first mistake.
V tach is refers to fast heart rate...well he didnt mention that did he?
So what else could have possibly cause a reverse in his r-wave? My first thought is mis-placed leads or as I said something less sever as low magnesium in his blood.
So Mr. Johnny Gauge...look at his symptoms before you go and try to diagnose his problems...you should get out your emt manual an refresh your vast medical knowledge...LOL

 

[maldorf]

My first thought is mis-placed leads

Probably this.

 

[Nssca]

I am amazed at the willingness to give worthless and dangerous advice! If this EKG was properly done, you may have some serious things to discuss with a cardiologist with a depressed or reversed R wave. A quick review of basic electrocardiography will explain this. Have the test repeated by someone who can perform it and then have it reviewed by a professional. Wow.

Dr 24

Telling someone to go get it checked by their physician and take an ekg form a trained professional is bad advice? I hope your not a real doctor...you just play one on the net..right?

 

[machola]

Telling someone to go get it checked by their physician and take an ekg form a trained professional is bad advice? I hope your not a real doctor...you just play one on the net..right?

Why do you think he was talking to you? Obviously he wasn't referring to your suggestion of going to go see a doctor.

 

[Nssca]

Why do you think he was talking to you? Obviously he wasn't referring to your suggestion of going to go see a doctor.

Well he posted just after me...right?
and what "Advise" did I give that was so dangerous or worthless?

 

[doctor24]

A good understanding of the QRST complex is needed. I am suprised that your professor could not tell you what this was. Seriously, have the test repeated and overread by a cardiologist and go from there is you are concerned. BTW, I am only a real doctor in my office and with my patients.

**this phenomonom with the poor progression of the R-wave is a common ECG finding that is often inconclusively interpreted as suggestive, but not diagnositic of anterior myocardial infarction (AMI). The differential diagnosis includes: AMI, left ventricular hypertrophy, right ventricular hypertrophy and a variant of normal with diminished forces. I wish you the best of luck. Also, Echocardiograms are a great way to follow your ECG evaluation and interpretation.

 

[Medic08]

Look it up its easy enough for even a paramedic to find. Taking a ekg from someone other than a trained medical provider was his first mistake.
V tach is refers to fast heart rate...well he didnt mention that did he?
So what else could have possibly cause a reverse in his r-wave? My first thought is mis-placed leads or as I said something less sever as low magnesium in his blood.
So Mr. Johnny Gauge...look at his symptoms before you go and try to diagnose his problems...you should get out your emt manual an refresh your vast medical knowledge...LOL

Your really trying to make me look like I dont know what I'm talking about after you said that Torsades was an inverted R wave? Hahaha this is comical.... Ok first off tachycardia refers to a fast heart rate, not Vtach. Ventricular tachycardia is not just a normal tachycardic rythm. Its is a very deadly ryhtm that sends the ventricles into a very fast heart rate.... If you were to look at an EKG you would see no P waves, a wide QRS > than .12 secs. and a rate between 151-300+.... As I said before Tosades is a polymorphic Vtach which means that the complexes are a different size and are coming froming a different foci in the ventricles and is treated differently than regular Vtach. "V tach is refers to fast heart rate...well he didnt mention that did he?" Ok then If you think I'm wrong then why the hell did you mention Torsades, because torsades is Vtach you jack ass. I didnt diagnose his symtoms, you did. All I did was correct your assinying misinturpretation of his EKG. So before you try and make me look stupid you should really know WTF your talking about because I do. Torsades has nothing to do with an inverted R wave. You made it seem like Torsades was some generic BS arrythmia that can be fixed by going to your local pharmacy and "picking up some magnesium". Hahahah ok..... Jesus some people think they know it all, I like how you think paramedics arent educated. Way to under estimate us.

This is Torsades.... If he was in Torsades he would not being casually talking to us right now.... Any more questions?
https://www.themdsite.com/graphics/Physician_04.jpg

 

[Medic08]

Well he posted just after me...right?
and what "Advise" did I give that was so dangerous or worthless?

Your "diagnosis" was far from the truth and honestly laughable. You gave a correct analysis on Torsades, but in the worst scenario. Keep it up though, your doing a great job

 

[Tylerman]

This is most likely due to lead placement.

 

[azz kikr]

ok first off this was just a class reading and we were learning how to read ECG's and the basics.
At first i could not get a reading. The right arm was placed on my AC joint and both legs were placed lined up with the hip and last rib bone. Since we couldnt get a reading we placed the right arm closer to my sterno clavicular joint and moved the legs higher. We finally got a reading and the R wave was inverted and it consistently had a double rivet in the R wave.
Now my proffesor is in the field of Exer Phys so he just knows the basics of ECG's and suggested an angled heart.

 

[Medic08]

ok first off this was just a class reading and we were learning how to read ECG's and the basics.
At first i could not get a reading. The right arm was placed on my AC joint and both legs were placed lined up with the hip and last rib bone. Since we couldnt get a reading we placed the right arm closer to my sterno clavicular joint and moved the legs higher. We finally got a reading and the R wave was inverted and it consistently had a double rivet in the R wave.
Now my proffesor is in the field of Exer Phys so he just knows the basics of ECG's and suggested an angled heart.

I would have to see a 12 lead to make a diagnosis, but your "double rivit" could be a bundle branch block. Like I said I would need to see a 12 lead to see how many leads it shows this and which leach it shows it in.... But the "double rivit" isnt just an axis problem. Thats a whole different thing. I would follow up with a cardiologist just to make sure.

 

[azz kikr]

Im gonna see tomorrow if he'll email me the 12 lead.

 

[Rex Feral]

An ECG reading where the points are "twisted" as in your case is termed as "Torsades de Pointes"

LOL, seriously, as others have said, you have absolutely no business handing out advice in this area. Then when you get called out on the complete absurdity of your above statement your reaction is to flame others who are actually giving out responsible advice. You obviously don't fully comprehend how stupid you look by saying this man was in torsade or you would have just kept your mouth shut or edited your post. Either that or you suffer from some mental pathology. In the event that you do not suffer from mental illness, try to have enough sense to realize when you have no idea what you're talking about and refrain from irresponsible, ignorant comments.

Rex.

 

[Medic08]

LOL, seriously, as others have said, you have absolutely no business handing out advice in this area. Then when you get called out on the complete absurdity of your above statement your reaction is to flame others who are actually giving out responsible advice. You obviously don't fully comprehend how stupid you look by saying this man was in torsade or you would have just kept your mouth shut or edited your post. Either that or you suffer from some mental pathology. In the event that you do not suffer from mental illness, try to have enough sense to realize when you have no idea what you're talking about and refrain from irresponsible, ignorant comments.

Rex.

Finally someone else understands!