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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
The Good News and the Bad News
Report:Sinus rhythm. LVH voltage. Comment:The bad news is that the patient was thought to have acute myocardial infarction and was given routine streptokinase infusion, resulting in a hæmorrhagic stroke. He was transferred to WVH later for rehabilitati
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
Cerebral Mimicry of MI
Report: Sinus tachycardia 127/min Right atrial abnormality VEB Acute inferolateral (or, better, inferior + anterior) myocardial infarction Prolonged QT interval Comment: The last item, QT prolongation, is the only clue that this is not an ordinary my
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
Long QT Interval Post-VF
Report:Sinus rhythm 65/min Right axis deviation +100o Late transition Long QT interval 0.54â QTc 0.56â Nonspecific ST/T changes Comment:She died from cerebral sequelae of her VF arrest; it is reasonable to ascribe the QT prolongation to cerebral
Sarcoidosis
Report:Sinus tachycardia 118/min PR interval 0.20â Right axis deviation Alternating (2:1) right bundle branch block Nonspecific ST/T changes Possible lateral infarction ?age Comment: The tracing, of course, provides scant clues to its provenance.
Myocarditis: the Cascade Effect
Report:Sinus tachycardia 122/min First degree AV block PR interval 0.22â Left anterior hemiblock Right bundle branch block ST/T changes c/c anteroseptal infarction or myocarditis Comment: Sinus P waves are best seen at the end of the T wave in th
LVH Voltage Despite Old Infarctions
Report:Sinus rhythm 92/min PR interval 0.20â LVH voltage (RL1 >20 mm, etc) Old anterior infarction Old inferior infarction Comment:Although the commonest cause of small voltage are large or multiple infarctions, the latter may coexist with large vo
HOCM
Report:Sinus rhythm 57/min Borderline first degree AV block PR 0.22â Right (or northwest) axis deviation +225o RsRâ V1 Poor R wave progression Possible right ventricular hypertrophy Left ventricular hypertrophy voltage Possible old inferolater
Fatal Pulmonary Embolism
Report:Sinus tachycardia 102/min ST/T changes c/c infarction/ischæmia Possible acute cor pulmonale S1T3 pattern Comment:This is a difficult tracing. The modest ST elevation in V1-2 is associated with what looks like reciprocal ST depression in infero