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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Adrenaline Bradycardia
Report:Sinus tachycardia 115/min (top) Sinus rhythm 90/min (bottom) VEBs Fusion beats Comment:The rate response is paradoxical, but well documented in normal volunteers. The pressor effect of adrenaline can evoke reflex slowing of the heart rate, over
Physiotherapy of Tetanus
Report:Sinus tachycardia Movement artefact (middle strip) Comment:The QRSs can be mapped out throughout the period of vibration physiotherapy - a familiar artefact in all the ICU units. A tetanic spasm would not be very different, but the patient should
Agonal Rhythm & Atrial âInfarctionâ
Report:Atria ?sinus rhythm Runs of accelerated idioventricular rhythm(s) AV dissociation (from third strip down) Progressive QRS prolongation in the AIVR or AJR Progressive PT segment elevation c/c atrial infarction Atrial ?sinus bradycardia (bottom
Chronotropic Incompetence
Report:Atrial fibrillation with âcontrolledâ response Accelerated idioventricular rhythm (AIVR) VEBs Comment:Although the ventricular rate appears favourable, it is in fact inappropriately slow in the setting of shock, pulmonary hypertension (see t
Right Heart in the Wrong Place
Report: Sinus rhythm Counterclockwise rotation (early transition) Q waves in 2, 3, aVF, V2-6 noted Minor T wave changes Comment: This is an example of a tracing impossible to interpret without the knowledge of its clinical context. The patient had con
VEA in CVA
Report:Sinus rhythm approx. 65/min Frequent VEBs in couplets, single one interpolated Left bundle branch block QRS 0.14â Comment:The VEBs are narrower in many leads than the LBBB sinus beats; this is not unusual in patients with bundle branch blocks
Hyperkalæmia
Report:Sinus rhythm 89/min Borderline first degree AV block PR interval 0.20â Right axis deviation +140o Intraventricular conduction delay QRS 0.13â Peaked T waves c/c hyperkalæmia Comment:All the T waves (even the inverted ones) are peaked, b
Acute Pancreatitis â Mime of Inferior MI
Report:Sinus tachycardia 132/min Probable acute inferior and anterior (V4) infarction Reciprocal ST segment depression in aVL Comment:In a patient with acute pancreatitis the likelihood of acute infarction remains remote. An ECG suggesting it is most l
LVH & RBBB
Report:Sinus rhythm 78/min Left atrial abnormality Third degree AV block Ventriculophasic sinus arrhythmia Junctional rhythm 42/min Right bundle branch block Left anterior hemiblock Frontal axis â 40o Left ventricular hypertrophy with ST/T chang
Brain-Stem CVA: SA Wenckebach
Report:Sinus rhythm 56 â 100/min Sino-atrial exit block, Möbitz 1 Minor T wave changes Lead V4 missing Comment:At first, seeing the typical grouping with acceleration before the pause, one thinks of AV Wenckebach. But there is no PR interval prolon