JP Mishra, MD, FACC

Upstate Cardiology. Rochester, NY. (seeking generosity, charity, friendship and passion for humanity).

[JP Mishra, MD, FACC @JPCardio]

@ecgdoujou A minor update: a PR more than 300 msec: the term used is Advanced or Marked 1st degree AV block.

[JP Mishra, MD, FACC @JPCardio]

@Javedakhtarjadu @Aestheticsn1 Toronto, taunt, test. Trent ( river).

[JP Mishra, MD, FACC @JPCardio]

@Dr_Shiv_kumar_ @DocPriyamMD @docakx @SameerYogi14 @daoo100 @MiguelP23970914 @Frances98392343 @shakilED @fzn733 A good point. However in lead V1: seems every P leads to QRS without any dissociation.

[JP Mishra, MD, FACC @JPCardio]

@TrackYourHeart #1 and 2 contradicting! #2: did you mean low voltage in limb leads?

[JP Mishra, MD, FACC @JPCardio]

@Dr_Shiv_kumar_ 1. A Fib with RVR could take up pace in WPW setup. However no A Fib here.
2. Inferior lead findings suggestive of MI ( actually pseudo-MI due to the delta waves)!

[JP Mishra, MD, FACC @JPCardio]

@o_o_dr I would argue for a very extensive antero-lateral MI with inferior extension involving likely a large Wrap-around LAD!

[JP Mishra, MD, FACC @JPCardio]

@TheECGMedic You meant HbA1C 15, right?

[JP Mishra, MD, FACC @JPCardio]

@ekgpress How about the tiny structures right before each QRS in leads V4 and V5. If not Ps, what could those be?

[JP Mishra, MD, FACC @JPCardio]

@TrackYourHeart Yes, everyone calling it R on T phenomenon, True. Most calling it being initiated by PVC, true. So that you know an early, aberrantly conducted PAC is a known, however less frequent cause of this phenomenon as well.

[JP Mishra, MD, FACC @JPCardio]

@physiosign So is it all about looking at fragmented QRS in aVR? No other leads? How did you find 70% LAD and 90% RCA findings? Cardiac Cath?

[JP Mishra, MD, FACC @JPCardio]

@abdulra_hman11 @alnmeeri24 You mean either the left or the right eye?😜

[JP Mishra, MD, FACC @JPCardio]

@CMEINDIA1 Just to add one more point in favor of significant LVH: When QRSs touching each other in a few contiguous precordial leads, it is called Seamen Sign!

[JP Mishra, MD, FACC @JPCardio]

@KostekMilan Those who might not know the famous singer Michael Jackson was given Propofol, in addition to other sedatives
prior to his unfortunate and premature demise!

[JP Mishra, MD, FACC @JPCardio]

@Dr_Shiv_kumar_ @daoo100 @DocPriyamMD @docakx @SameerYogi14 @Frances98392343 @shakilED @FrdBjk112 @fzn733 @FibrilloFlutter @MiguelP23970914 1. Do consider frequent PACs in an atrial bigemny pattern with more prominent Ps 2. Mild electrical alternans 3. Lead I sign ( Samroth sign): (bare minimal voltage seen in lead I) suggestive of COPD/emphysema.

[JP Mishra, MD, FACC @JPCardio]

@Arron_Pearce_ Next week: Boston marathon: my son is running. We will be going to Boston to watch him run. He has been running Boston marathon every year for the last 9 years. We go every year to support him. Best of luck to you!

[JP Mishra, MD, FACC @JPCardio]

@MJAckermanMDPhD @Hragy @EndeavorAir Lovely! She is officially not only ATP for herself but on a daily basis for you as well! You being in medicine/ cardiology, I don’t need to remind you what ATP stands for!!
Your ATP: Better than coffee!
Congratulations to all of you!!

[JP Mishra, MD, FACC @JPCardio]

@KostekMilan Another word for ECG:
EKG (elektrokardiogramm), a German word!

[JP Mishra, MD, FACC @JPCardio]

@Arron_Pearce_ @The_Nanashi_O @RobertHermanMD @BaoGTran @PMcardioApp @smithECGBlog What about the QRSs being upside down also in leads I and aVL, however Ps being normal in orientation in those two leads and in V2 as well?

[JP Mishra, MD, FACC @JPCardio]

@KostekMilan Any EP idea as to why PR should be short in these cases?