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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
LBBB with RAD: Acute Inferior Infarction
Report:Sinus rhythm 96-100/min Third degree AV block Junctional escape rhythm 45/min Left bundle branch block Right axis deviation +95o Acute inferior infarction Comment:Three contributors to heart failure are present in this trace: Acute infarction
LBBB with Transient Right Axis Deviation: Ischæmic Cardiomyopathy
Report: Sinus rhythm Right axis deviation (RAD) + 140o Left bundle branch block Comment: The unusual combination of LBBB and RAD is a surprisingly specific marker of congestive cardiomyopathy29. This patient had CABG following an inferolateral MI; subs
Left Axis Deviation: Inferior Infarction
Report:Sinus rhythm 60/min Left axis deviation â60o Inferior and anterior infarction, probably old Comment:Deep Q waves of inferior infarction are a common cause of LAD in cardiac patients. They distinguish infarction from LAHB, which requires rS mor
Left Axis Deviation: LAHB
Report:Atrial & sinus rhythm 76/min Left atrial abnormality (LAA) Left anterior hemiblock Axis â40o Early transition Left ventricular hypertrophy with ST/T changes Comment:There is a typical qR and rS pattern in leads 1 and 3, respectively. Also t
Supernormal Conduction in LBBB
Report:Atrial fibrillation with ventricular response 93/min Left bundle branch block, intermittent Supernormal conduction Probable LVH with ST/T changes (incomplete LBBB) Comment:The transition to narrow(er) QRS toward the end of the recording occurs
Left Axis Deviation: Axis Illusion of Emphysema
Report:Sinus rhythm 92/min Left axis deviation â80o Right atrial abnormality (RAA) Q waves in 3, aVF Comment:Although it is not an abnormality per se, the QRS complexes in emphysema are often characteristically slender. The P waves are pointed and
Pædiatric Wolff-Parkinson-White Conduction
Report:Sinus rhythm 190/min Wolff-Parkinson-White conduction, type âAâ Comment:At the age of one to two months, the rate below 191/min is not reported as tachycardia. Atrial activity is barely visible but, where seen, remains consistent with sinus r
Right Axis Deviation: Lateral Infarction
Report:Sinus tachycardia 110/min Right axis deviation +150o Postero-antero-lateral infarction, probably recent Comment:The Q waves in the (high) lateral leads 1 and aVL are responsible for the RAD. They are called âlateralâ by convention and do not
AV Block: Nodal or Ventricular?
Report:Sinus rhythm Second degree AV block Intermittent right bundle branch block & left posterior hemiblock Prolonged QT interval Comment:The PR interval lengthens between the first and the second beat, but fails to grow observably longer between the
Intraventricular Conduction Delay
Report:Atrial fibrillation with rapid ventricular response 159/min Intraventricular conduction delay (IVCD), QRS 0.26â Comment:The tracing has some elements of RBBB with marked LAD due to QS in lead 2 and Qr in 3 and aVF. In lead 1, however, the initi