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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Positive Concordant Pattern: Masquerading BBB
Report: Sinus rhythm Left atrial abnormality Possible right atrial abnormality First degree AV block PR interval 0.22â Alternating atrial (?sino-atrial) pacemaker (rhythm strip)[!xe "Alternating atrial pacemaker!] Atrial bigeminy Right bundle bra
âTrifascicularâ Block
Report: Sinus rhythm Left atrial abnormality (LAA) First degree AV block PR 0.28â Left posterior hemiblock Right bundle branch block Old anterior infarction Comment: The term âtrifascicularâ is sufficiently polysyllabic and scientific-soundin
Left Axis Deviation in AV Canal Defect
Report:Sinus rhythm 88/min Left axis deviation â60o Incomplete right bundle branch block Comment:Although morphologically indistinguishable from LAHB, the LAD in AV canal defects has different pathology. One should always suspect ostium primum ASD or
RBBB as Monophasic R wave in V1
Report:Sinus rhythm 94/min Left anterior hemiblock QRS axis â40o Right bundle branch block Comment:RBBB can be manifest as pure R wave in V1, especially in the presence of a hemiblock. One could not, without a baseline trace in sinus rhythm, diagnos
Left Posterior Hemiblock Following Aortic Valve Replacement
Report:Sinus rhythm 98/min Right bundle branch block Left posterior hemiblock Axis +115o Nonspecific ST/T changes Comment:One can only diagnose the LPHB with clinical exclusion of RVH. It is easy if the hemiblock suddenly appears or disappears, as in
Bilateral Bundle Branch Block (BBBB)
Report: Sinus tachycardia 110/min Left atrial abnormality (LAA) Right axis deviation (RAD) +120o Probable left posterior hemiblock Right bundle branch block ST/T changes consistent with infarction/ischaemia Comment: Three years previously, this pati
Fusion Beats in Idioventricular Escape Rhythm
Report:Sinus bradycardia 27/min First degree AV block Right bundle branch block (by inference) Right bundle branch escape rhythm 28/min Fusion beats Comment:As the PR interval shortens the QRS gets fatter. This means that the P waves are conducted. T
Bilateral Bundle Branch Block
Report:Sinus tachycardia 113/min Left anterior hemiblock Right bundle branch block Comment:This is only a bifascicular block â complete right and partial left bundle branch block. The term BBBB is not usually used for this. But if, as here, the patie
Masquerading and Left BBB: BBBB
Report:Atrial fibrillation with rapid ventricular response 150/min Right bundle branch block Left anterior hemiblock Left bundle branch block Bilateral bundle branch block. Nonspecific ST/T changes Comment:In this case one can diagnose BBBB directly
1o AV Block Expressing BBBB
Report: Sinus rhythm 77 â 82/min Left atrial abnormality (LAA) First degree AV block PR 0.22â Intermittent right bundle branch block + left anterior hemiblock PR 0.16â Nonspecific T wave changes Comment: At first, one would postulate a disso