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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
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
Somatic Tremor
Report: Sinus rhythm SVEB Borderline LVH voltage Somatic tremor Comment: Fortunately, the tremor from the limbs cancelled itself in lead 2152. The frequency of the tremor, approximately 5/sec (like atrial flutter), suggests Parkinsonâs disease. True
Movement Artefact Simulating VEBs
Report:Sinus rhythm 80/min Within normal limits Movement artefact in simultaneous V4-6 & V1 strip Comment:The computer diagnosed a (single) VEB. If there were a single VEB, it would have been about 0.56â in duration! It is easy to see, once thought
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
TachypnÅa
Report: Supraventricular tachycardia, probably sinus, 108/min Respiratory movement artefact 39 - 44/min Comment: The marked respiratory movement virtually invalidates ECG monitoring. The same would happen to pulmonary artery pressure trace. A side benef
Epilepsy
Report: Sinus rhythm Movement artefact consistent with tremor or fitting Comment: The rapid regular rhythm of both episodes is beyond the power of most percussion physiotherapists; at any rate (or, better, at this rate!), the patient was fitting. Vibrat
A Sticky Roller
Report: Sinus rhythm Right bundle branch block Paper speed artefact Comment: The immediate action would be to check the paper path of the monitorâs writer. Note how, in some of the distorted beats, the T waves are unaffected: it all depends on timing
Peyronie's Disease of the Heart
Report: Peyronie's disease196 of the ECG machine. Comment: The characteristic curvature is seen not only on the patient's complexes, but also on the machine standardisation artefact. The problem was a displaced heated stylus on an older ECG machinemode
Electromechanical Association: Spurious VT
Report:Sinus tachycardia. Incomplete RBBB. Movement artefact. Comment:The movement artefact occurs at the same rate as the pulse. The patient had a forceful precordial impulse, which visibly moved the lead attachment. I could not reproduce the original
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