1. MedEd 2
MEDICAL STUDENT
ECG and CXR
Worked examples
Sam Ravenscroft

2. ECG 1
Image used from lifeinthefastlane.com

3. Pericarditis Saddle shaped ST elevation across multiple leads
Differentiation from STEMI?
QRS complexes and T waves remain unchanged
ST elevation is concave and no more than 5mm from J point
Across multiple leads*

4. Large STEMI
Image used from

5. ECG 2
Image used from lifeinthefastlane.com

6. Left Bundle Branch Block
Broad QRS in a WiLLiaM pattern
Dominant S wave in V1
Left axis deviation
It’s unusual to have LBBB without organic disease...
NEW LBBB + Chest pain is a worry for MI
Secondary to hypertrophy e.g. Hypertension, Aortic stenois

7. Right Bundle Branch Block
Broad QRS in a MaRRoW pattern
RSR complex in V1
RBBB can be a normal variant, but other causes include RVH, ischaemic injury, congenital disease.

8. Chest X-Ray 1

9. Chest X-Ray 2

10. Consolidation Collapse
“Cotton wool” density
Uniform density with smooth edges
Lung markings persist
May see air bronchograms
No lung markings
No features of volume loss
Volume loss e.g. Shift of structures
May have associated effusion
Associated effusion only if related to shared cause e.g. Tumour
Causes: Fluid in the alveoli
Pus – infection
Water – oedema
Blood – haemoptysis?
Causes: proximal obstruction of airflow
-Luminal e.g. FB or mucus plugging
-Mural e.g. tumour
-Extrinsic compression