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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Acute Inferior Infarction: Anterior Reciprocal Changes
Report:Sinus rhythm 82/min First degree AV block PR interval 0.28â Acute inferior infarction Comment:The tracing is remarkable in that both lateral all the precordial leads show reciprocal ST segment depression, more than the previous example in Fig
Absolute Small Voltage & Its Commonest Cause
Report:Sinus rhythm 77/min Absolute small voltage Anterior infarction, age indeterminate Comment:This patient, too, had history of a remote infarction; like the previous case, he too could have a ventricular aneurysm. He was asymptomatic and there was
Ventricular Tachycardia: Pseudo P Waves at Either Complex End
Report:Sinus rhythm 84/min. Ventricular tachycardia 132/min. Complete AV dissociation. Comment:The broad-complex tachycardia has QRS duration 0.20", extreme "Northwest" axis and, best of all, taller left rabbit ear in V1 to declare its ventricular orig
Ventricular Tachycardia?
Report: Broad complex tachycardia 154/min ?Sinus or SVT with aberrant conduction and massive ST segment elevation Right axis deviation (RAD) +140o Right bundle branch block Probable acute inferior infarction Comment: The tachycardia looks bizarre eno
AIVR & Quadrigeminal VEBs
Report: Accelerated idioventricular rhythm 90/min (AIVR) Retrograde VA conduction Wenckebach phenomenon VEBs in quadrigeminy Fully compensatory pauses (in the AIVR) testing Comment: The first impression is that of dissociated sinus rhythm due to vari
Let the Sleeping Dog Lie?
Report:Sinus arrhythmia 45 - 68/min Second degree AV block Two blocked P waves Comment:It is disconcerting to see a spontaneous 3.7" pause, but (i) the patient had a recent inferior MI and (ii) remained asymptomatic during similar episodes while awake.
Pædiatric SVT
Report: Orthodromic atrioventricular re-entrant tachycardia 333/min Possible flutter with 1:1 conduction Left bundle branch block ?Wolff-Parkinson-White syndrome ( see below) Comment: The rate is very fast, but an infantâs flutter can be much faster
CPR: Staring at the Monitor
Report: Ventricular fibrillation Sinus rhythm (post-cardioversion) Third degree AV block - ventricular asystole CPR artefact Comment: Nothing happened for over 7 seconds, the staff looking at the monitor. Closed chest compression should resume a lit
Spurious ST Segment Elevation
Report: Sinus bradycardia 43/min Left atrial abnormality First degree AV block Escape-capture bigeminy Third degree AV block (mid-second strip onward) Junctional rhythm 64/min Comment: The broad shallow sinus P waves, with their first degree AV bl
Rapid Cure of Silent Ischæmia
Report:Sinus rhythm ST segment depression c/w ischæmia Comment:This one was delightfully easy to solve. The strips showing ST depression were all obtained with the patient sitting out in a chair, completely asymptomatic. I sat her up in bed to see the