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WORKING THE ELECTROCARDIOGRAMS
ELECTROCARDIOGRAM SCORESHEET
CATHSOURCE
ECHOSOURCE
Currently, there are 531 unique electrocardiograms in the database with more being added monthly. Once you complete all of the ECGs in our database, the electrocardiograms will continuously recycle, enabling you to interpret thousands of tracings over years of training.
Once you have submitted your answer for a specific electrocardiogram, you cannot change your answer. You can
review any electrocardiogram that you previously worked, including the tracing itself, as well as your answer
and scoring assessment, by clicking on the ECG Tracker link in the side-menu after logging in.
A timer exists in the upper right hand corner of the ECG Reading Room to give you a general idea of how long you spend working on each tracing. You will be
given unlimited time for each ECG, but individuals taking the American Board of Internal Medicine Cardiovascular Disease exam should be
aware of standard time constraints regarding the electrocardiogram section. Previous exams have typically allowed approximately 3 minutes to view and code each tracing.
You may display ECG calipers by clicking on the appropriate button in the upper left hand corner of the ECG Reading Room. Use the mouse to click and drag the right side of the calipers to create your desired caliper width. Click within the middle of the calipers to drag them across the page.
If Q waves exist with concomitant ST-elevation and I code for "Age recent, or probably acute" Q wave myocardial infarction, do I also need to code for "ST and/or T wave abnormalities suggesting myocardial injury?"
No. Any "Age recent, or probably acute" Q wave myocardial infarction, by definition, will have ST and/or T wave abnormalities suggesting myocardial injury. It would be redundant to code for both on the scoresheet, and for this reason, when you code for any "Age recent, or probably acute" Q wave myocardial infarction, the box for "ST and/or T wave abnormalities suggesting myocardial injury" will be disabled, as this answer is already implied. You should only code "ST and/or T wave abnormalities suggesting myocardial injury" when such changes are present in the absence of any pathological Q waves.
If there is diffuse ST-elevation and I code for "Acute Pericarditis," should I also code for "ST and/or T wave abnormalities suggesting myocardial injury?"
No. Acute pericarditis must be distinguished from a transmural myocardial infarction because those two separate entities are treated very differently. The code for "ST and/or T wave abnormalities suggesting myocardial injury" should be reserved to describe a coronary event that has resulted in a transmural myocardial infarction. Although epicardial inflammation may result from acute pericarditis, this process is not routinely associated with transmural myocardial injury and should not be scored as such. For this reason, when you code for "Acute Pericarditis," the box for "ST and/or T wave abnormalities suggesting myocardial injury" will be disabled.
No. By definition, "Left anterior fascicular block" will always have "Left axis deviation," and it would be redundant to code for both. Therefore, when you code for "Left anterior fascicular block" on the scoresheet, the box for "Left axis deviation" will be disabled, as this answer is already implied.
No. By definition, "Left posterior fascicular block" will always have "Right axis deviation," and it would be redundant to code for both. Therefore, when you code for "Left posterior fascicular block" on the scoresheet, the box for "Right axis deviation" will be disabled, as this answer is already implied.
Should I code for "ST and/or T wave abnormalities suggesting myocardial ischemia" (i.e. ST-depression) when an acute infarction (ST-segment injury) is also present?
No. Acute Q wave myocardial infarctions are suggested by the presence of Q waves and ST-elevation. Often reciprocal ST-depression is also seen. These ST-depressions are not indicative of ischemia, but exist as a consequence of the myocardial injury. For this reason, if you code for "Age recent, or probably acute" Q wave myocardial infarction or "ST and/or T wave abnormalities suggesting myocardial injury," do not also code for "ST and/or T wave abnormalities suggesting myocardial ischemia."
Currently, there are 22 high-yield CathSource cases organized in question format. CathSource images may be coronary angiograms, ventriculograms (right or left), and aortograms. One or more images may exist for each case.
Currently, there are 22 high-yield EchoSource cases organized in question format. EchoSource images may be transthoracic and/or transesophageal echocardiograms. One or more images may exist for each case.
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Electrocardiogram ECG/EKG Medical Education & Imaging Board Exam Review/Preparation ★ Copyright © 2008 ECGsource | All Rights Reserved | Copyright Info