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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Hyperkalæmia
Report: Supraventricular tachycardia, probably sinus, 128/min Right bundle branch block Left anterior hemiblock Tall T waves suggest hyperkalæmia Comment: Hyperkalæmia diminishes the amplitude of P waves; they eventually disappear altogether, with a
Hypocalcæmia
Report: Sinus rhythm 70/min Nonspecific lateral T wave changes Prolonged QT interval QTc 0.50â Comment: Although the QT interval is prolonged, the T wave is usually fairly normal in hypocalcæmia. This may explain the rarity of torsades de pointes:
Global T Wave Inversion
Report: Sinus rhythm Old inferior infarction Probable left ventricular hypertrophy Global T wave inversion[! XE "Global T wave inversion" \t "See T wave:inversion" !] Comment: The patient was septic with peritonitis and had unstable blood pressure, wi
RVH in COAD
Report: Atrial fibrillation, mean ventricular rate 85/min Right axis deviation + 130o qRV1, probable right ventricular hypertrophy Nonspecific ST/T changes Comment: RVH is seldom expressed as dominant R wave in V1 in COAD; the commonest change is RAD
Emphysema: α-1 Antitrypsin Deficiency
Report: Sinus rhythm Left axis deviation â 80o Comment: The commonest cause of LAD is LAHB; in middle-aged men, the commonest cause of LAHB is underlying coronary disease, often subclinical. This trace looks like LAHB, down to QR in aVR and RS in V6.
Emphysema: Northwest Axis
Report: Sinus tachycardia 130/min Right atrial abnormality P axis +85o Indeterminate abnormal axis +250o S1S2S3 pattern Poor R wave progression RSRâ in V1-2 Comment: The patient had advanced emphysema, with dilated right ventricle and clinical c
Parkinsonâs Disease & AF
Report: Atrial fibrillation Nonspecific ST/T changes Somatic tremor Comment: The patient had severe, disabling parkinsonism. Atrial activity is difficult to make out, but the irregularly irregular ventricular rate points to atrial fibrillation. Presen
PR Segment Shift in Pericarditis
Report: Sinus rhythm 88/min PR segment shift consistent with pericarditis (best seen in leads 1, 2, aVR and V2) Minimal ST elevation 2, 3, aVF Comment: The computer reported minimal ST segment elevation in the inferior leads, but I thought I knew bette
Rhythm Strip Bump: P Wave or Artefact?
Report: Sinus bradycardia 25/min Junctional escape beats Escape-capture bigeminy Right axis deviation Right bundle branch block Old anteroseptal infarction Lateral infarction or ischæmia Possible right ventricular hypertrophy Comment: Congenital
Right Atrial Abnormality
Report: Sinus tachycardia 130/min Right atrial abnormality 5 mm P wave in Lead 2 P wave axis + 90o Vertical heart position Comment: The inferior ST segment depression (using T-P baseline) may be due, at least in part, to prominent Ta waves, inferred