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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Atrial-Sensing Pacemaker in AF
Report: Atrial flutter/fibrillation 2 Dual-chamber pacemaker 3 Tachycardia up to 129/min due to atrial (over)sensing 5 Comment: The pacemaker is programmed to follow – up to a set upper rate limit – atrial activity. This is really meant for sinus rhyth
Pacemaker Rhythm and LBBB
Report: Electronic demand pacemaker rhythm 70/min 2 Atrial fibrillation 2 Left bundle branch block (last 3 beats) 6 Comment: If it were not for the rhythm strip, few would notice the transition from pacemaker to supraventricular rhythm at the end of th
Status Asthmaticus
Report: Sinus rhythm Right atrial abnormality ST/T changes consistent with ischæmia or hypoxia Comment: Tachycardia is conspicuous for its absence and is as sinister as was the absence of audible wheezing. The repolarisation changes reflect profound
Tricuspid Atresia
Report: Atrial pacemaker rhythm 111/min (dual chamber pacemaker) 4 Left axis deviation (LAD) –60o 3 LVH with ST/T changes 3 Comment: A cyanosed child with LAD most likely has tricuspid atresia; in one large series LAD was present in 87% of those wit
Anterior Infarction From the First and Last Smoke
Report:Sinus rhythm 55/min Old anteroseptal infarction Comment:This is a rather unremarkable outpatient tracing, showing QS complexes in V1-2, very small R in V3 and abnormal T waves in 1 and aVL. There is no âseptalâ q wave in a small V6 complex â
Isolated U Wave Inversion
Report: Sinus rhythm 82/min Nonspecific T wave changes T3 > T1, TV1 > TV6, consistent with ischæmia Negative U waves Comment: U waves are common; their isolated (from the T wave) negativity is rare and constitutes a surprisingly specific marker of th
Respiratory Artefact
Report: Sinus tachycardia 122/min rSRâ pattern in MCL1 Respiratory artefact Comment: The heatâs position vis à vis the recording MCL1 electrode changes phasically with breathing. Not only the QRS size, but the polarity of the T wave is affected. T
Acute Anterolateral and Old Inferior Infarction
Report:Sinus rhythm 74/min VEB RAA + LAA Left axis deviation -35o Old inferior infarction Acute anterolateral infarction Comment:There is some slight ST elevation in the high lateral leads and marked one in V4-6 with reciprocal changes in V1-2. The
Reversible ST Segment Depression Myocardial Infarction
Report:Atrial fibrillation with ventricular response 65 â 103/min Precordial ST segment depression c/w infarction/ischæmia Comment:The CPK showed a rise to 900 U/L, while the troponin remained, unaccountably, negative. Later it transpired that there
RVH
Report:Sinus rhythm 70/min Right axis deviation + 130o qRV1 â right ventricular hypertrophy Comment:Most ECGs looking like this would suggest primary pulmonary hypertension, especially in a young woman. The heart has a limited repertoire: this exampl