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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Low-Atrial Pacemaker
Report:Atrial pacemaker rhythm 70/min 2 Retrograde P wave pattern 7 Nonspecific T wave changes 1 Comment:At first I thought the electrode had been inserted into the coronary sinus. It turned out the heart had been paced more conventionally through the
Juvenile Notch
Report: Sinus rhythm Axis +90o Early transition Normal trace Juvenile notch Comment: The interesting part of the ECG are leads V2 and V3, where a prominent juvenile notch of the T wave mimics 2:1 AV block. If only these two leads were available, it w
Dextrocardia with RBBB
Report: Sinus rhythm Mirror-image dextrocardia Right bundle branch block Nonspecific ST/T changes Comment: The precordial sequence gives the diagnosis. In the (much commoner) situation of technical armsâ lead reversal153, the V leads are unaffected.
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
The P-on-U Effect
HypokalæmiaReport: Sinus tachycardia 135/min Non-specific ST/T changes Prominent U waves Consistent with hypokalæmia Comment: As stated earlier, the pun is Schamrothâs174. This second example is to reward the fast learners. The large U wave is su
Lead 2 Monitoring
Report: Sinus rhythm P wave axis -30o Probable left ventricular hypertrophy Comment: Lead 2 was once the traditional monitoring lead. This was based on the fact that, if the P waves were - as they usually are - positive in all three standard leads, lea
Inverted P Wave in Lead 1
Report:Sinus rhythm 97/min Inverted P wave in L1 ?cause P axis +100o Left ventricular hypertrophy voltage Comment: In L1 atrial deflections are biphasic, mostly negative; elsewhere the P wave, while atypical, would pass muster were it not for the L1
Dextrocardia in Situs Inversus Viscerum
Report:Sinus rhythm 92/min Dextrocardia Nonspecific T wave changes Comment:Oddly enough the computer diagnosed âregular rhythm with unusual P axisâ, as though negative P wave in L1 is merely âunusualâ. It also went the full hog: âanterolatera
Wenckebach AV Block in Sinus Tachycardia
Report: Sinus tachycardia 106/min Right atrial abnormality (RAA) Second degree AV block, Möbitz 1 Up to 0.48â PR Intervals Junctional escape beat (third last QRS) LVH with ST/T changes Comment: The 4:3 and 5:4 Wenckebach cycles seen from beginni
Respiratory & Ventriculophasic Sinus Arrhythmia
Report: Sinus rhythm Respiratory sinus arrhythmia Ventriculophasic sinus arrhythmia Second degree AV block, Möbitz 1 Period of 2:1 conduction + one 5:4 cycle LVH with ST/T changes ± digoxin effect Comment: The ventriculophasic effect â P-P inter