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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Volume Overload LVH
Report:Sinus rhythm 75/min Left atrial abnormality Left ventricular hypertrophy voltage Prominent T waves c/w volume overload Comment:In the diastolic overload of chronic aortic or mitral incompetence T waves may not only remain upright with LVH, but
Axis Illusion in Emphysema
Report:Sinus tachycardia 110/min Right atrial abnormality P axis +85o Left axis deviation QRS â90o Late (or no) transition Comment:An immediate clue that the LAD is not due to an LAHB (its commonest cause, overall) is that S2 > S3, opposite of w
An Unusual Agonal Alternans
Report: Sinus bradycardia 46/min First degree AV block PR 0.64â Second degree AV block, 3:2 then 2:1 Left atrial abnormality Left bundle branch block QRS 0.42â T wave alternans Comment: The T wave is unaccountably flattened in alternate cycles
Faulty Calibration
Report: Sinus rhythm Faulty standardisation (upper left-hand corner) Sloping ST segment depression probably due to faulty standardisation Comment: The repeat trace in the CCU was completely normal (Fig 201a below). Instead of receiving an apology and
P-on-U Phenomenon in Hypokalæmia
Report: Sinus rhythm Non-specific ST/T changes Prominent U waves consistent with hypokalæmia Comment: The patient was in fact hypokalæmic at 2.9 mEq/L - a frequent finding in sick alcoholics, especially after prolonged vomiting with attendant alkalos
Pseudopseudoblock
Report: Sinus tachycardia SVEB (second beat) Non-specific ST/T changes Electrode artefact V4-6. Comment: Isolated non-conducted P wave, without any disturbance of the sinus rate, is what a pseudoblock due to a concealed bundle of His extrasystole woul
Pædiatric RVH: Upright TV1
Report: Sinus rhythm 160/min [rate 110-178 3-11 months] Left atrial abnormality Right axis deviation +120o [normal for age] Right ventricular hypertrophy Left ventricular hypertrophy voltage RV6 = 30 mm Possible biventricular hypertrophy Comment: T
Dextrocardia and Acute Myocardial Infarction
Report: Sinus rhythm Dextrocardia Acute inferolateral infarction Old anteroseptal infarction Comment: The unusual occurrence of right-sided chest pain is well-recognised in patients with inferior infarction and dextrocardia148. The reason for this is
Spurious Pulmonary Embolism
Report: Sinus rhythm Reversed arm leads Left atrial abnormality Borderline T wave changes. Comment: The trace was taken 9 hours after the one in Case 211, presumably because of further chest pain. The interesting thing is, of course, the physicianâs
LVH with Right Axis Deviation
Report: Atrial tachycardia (flutter) 208/min with 2:1 block Axis +90o Small voltage, limb leads Left ventricular hypertrophy with ST/T changes Comment: The rate of the flutter is very slow, presumably due to flecainide therapy; it was only reported as