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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
P Wave or T Wave?
Report:Sinus bradycardia 37/min. Left atrial abnormality . First degree AV block. Left bundle branch block Comment:The T wave is peaked and sharply demarcated from the preceding ST segment, mimicking a P' wave. Sequential strips (Fig 224a below) gradu
Truncal Vagotomy and the T Wave
Report:Sinus ? atrial rhythm. Borderline left axis deviation -30o LVH voltage. Incomplete RBBB. Non-specific ST/T changes. Comment:The ST/T changes are non-specific (they always are) but the "widely splayed" T wave inversion, most marked in anterosep
Mitral Incompetence: LV Volume Overload
Report:Sinus rhythm. Left atrial abnormality Normal axis. Left ventricular hypertrophy with volume overload pattern. Comment:Tall prominent T waves and, later, merely upright ones, constitute the LV volume, or diastolic, overload pattern. It can only
Hyperkalæmia: IVCD
Report:Broad complex rhythm of uncertain origin 68/min. Possible sinoventricular conduction with intraventricular conduction defect. Peaked T waves. Trace suggestive of hyperkalæmia. Comment:The absent P waves, widened QRS and the tall, peaked T wave
Phasic T Wave Inversion
Report: Sinus arrhythmia Respiratory swing of QRS & T wave axis Comment: This is not uncommonly seen in right precordial leads, including the monitor leads. It may be significant if only one or two cycles are recorded on a 12-lead ECG. See Case 211. 23
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,
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
Peaked Waves After Head Injury
Report:Sinus rhythm 80/min Borderline right axis deviation +90o Right atrial abnormality Tall peaked T waves ?cause Prolonged QT interval QTc 0.50â Comment:The T waves are, of course, typical of hyperkalæmia: narrow-based, tall and peaked. There
LVH: Left Ventricular Volume Overload
Report:Atrial fibrillation with controlled response (56/min) Left anterior hemiblock (frontal plane QRS axis -50o) Poor R wave progression Left ventricular hypertrophy (RV5 > 25 mm) Prominent T waves consistent with LV volume overload Comment:The pat
Global T Wave Inversion
Report:Sinus rhythm Normal axis LVH with ST/T changes ± ischæmia Comment: The peculiar thing is that this kind of T wave inversion has a striking preponderance in the elderly woman and is usually not ischæmic, let alone infarctional203. The pattern