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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Electrical Interference
Too Fast for Natural CausesReport: Sinus rhythm SVEBs Left ventricular hypertrophy with ST/T changes Electrical interference Comment: This is not the typical 50 Hz AC interference, but is fast enough not to be a somatic tremor. Itâs too fast for nat
COAD: P Pulmonale Causing ST Segment Depression
Report: Sinus tachycardia 117/min Right atrial abnormality Small voltage (absolute) Late transition Borderline ST segment changes Comment: The P wave axis is 86o, with 0.4 mV amplitude in lead 2 and the characteristic peaked shape. As often happens
Sluggish Performance of Fat Complexes
Report: Atrial fibrillation with controlled response (top & bottom) Mean BP 85 & 83 mmHg Pacemaker rhythm (middle) Mean BP 68 mmHg Comment: The slight asynchrony in contraction secondary to LBBB-type conduction becomes significant in a critically imp
Tall T Waves: Myocardial Rupture
Report: Sinus rhythm Third degree AV block Junctional escape rhythm 43/min Prominent T waves Comment: A rare cause of tall T waves, not unlikely in this case, is free wall rupture167. Other causes (infarction, reciprocal change to remote infarction,
Agonal Rhythm
Report: Atrial standstill VEBs (ventricular escape beats) Ventricular tachycardia 110/min Comment: Despite its irregular rate, the broad complex tachycardia is unlikely to represent ventricular response to atrial fibrillation. The agonal rhythm is usua
Over the Top
Report: Sinus rhythm First degree AV block (shortest PR 0.48â)[!xe "AV block:first degree:skipped P waves" \b!] Second degree AV block, Möbitz 1 (Wenckebach) Skipped P waves (over the top conduction)[!xe "P wave:skipped" \b!] Comment: This is quite
Prolonged QT Interval
Report: Sinus rhythm 54/min Prolonged QT interval 0.56â QTc 0.53â Comment: This trace suggests anteroseptal infarction, with QS complexes in V1-2 and anteroseptal T wave inversion. However, the âseptalâ q wave in V6 is preserved, which is unusu
Endocardial Cushion Defect & Biventricular Hypertrophy
Report:Sinus rhythm 63/min First degree AV block PR 0.22â Right atrial abnormality Left anterior hemiblock LAD â65o RSRâ in V1 Biventricular hypertrophy Katz-Wachtel phenomenon: QRS 67 mm in V4 Nonspecific ST/T changes Comment:The interes
RVH with AF in COAD
Report: Atrial fibrillation (coarse) with rapid ventricular response Phasic aberrant conduction, probably incomplete RBBB (6th beat in aVR) Right axis deviation Right ventricular hypertrophy (RVH) Probable left ventricular hypertrophy (LVH) Comment:
Isoprenaline in Myocarditis
Report: Sinus tachycardia 102/min (Probable) incomplete RBBB Left anterior hemiblock Marked ST segment elevation Cascade effect Comment: In septal leads there is a gross elevation of the ST segment, which merges into an inverted T wave. This is the c