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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Delectable Deductive Diagnosis of RBBB/LPHB
Report: Dual chamber pacemaker rhythm 70/min 2 Frontal plane axis –20o 2 Ventricular fusion complexes throughout 3 Probable underlying right bundle branch block with right axis deviation 3 Comment: I make no apologies for the subcontinental flavour of
Fascicular VT in Anterior Infarction
Report:Ventricular (fascicular) tachycardia 103/min RBBB/LAHB morphology Acute anterior infarction Comment:It is possible that the tachycardia is junctional, with aberrancy, except that lead 1 does not look right for RBBB, with or without LAHB; also, i
Gitelmanâs Syndrome: Hypokalæmia
Report:Sinus rhythm 85/min Right axis deviation +140o Right bundle branch block Large TU waves c/w hypokalæmia Comment:This is, almost, a P-on-U phenomenon (no pun intended), as Schamroth put it11. The diagnosis can only be made, as reported, in a co
Alternating LBBB with Right Axis Deviation
Report:Sinus rhythm 93/min Alternating complete & incomplete left bundle branch block Axis +95o with complete LBBB Indeterminate axis with incomplete LBBB Comment:The basic LBBB morphology is, as always, best seen in lead V1. In the limb leads, both c
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
LBBB with RAD: Acute Inferior Infarction
Report:Sinus rhythm 96-100/min Third degree AV block Junctional escape rhythm 45/min Left bundle branch block Right axis deviation +95o Acute inferior infarction Comment:Three contributors to heart failure are present in this trace: Acute infarction
LBBB with Transient Right Axis Deviation: Ischæmic Cardiomyopathy
Report: Sinus rhythm Right axis deviation (RAD) + 140o Left bundle branch block Comment: The unusual combination of LBBB and RAD is a surprisingly specific marker of congestive cardiomyopathy29. This patient had CABG following an inferolateral MI; subs
Right Axis Deviation: Lateral Infarction
Report:Sinus tachycardia 110/min Right axis deviation +150o Postero-antero-lateral infarction, probably recent Comment:The Q waves in the (high) lateral leads 1 and aVL are responsible for the RAD. They are called âlateralâ by convention and do not
Right Axis Deviation: RVH
Report:Sinus rhythm 92/min Biatrial abnormality (LAA + RAA) Right axis deviation +115o Right bundle branch block Inferior and anterior Q waves ? cause Probable right ventricular hypertrophy Comment:The patient had very large dilated and hypertrophie
Alternating Retrograde Conduction in Accelerated Junctional Rhythm
Report:Accelerated junctional rhythm 92/min 2:1 retrograde block Right axis deviation Lateral infarction, acute or recent Borderline small voltage in frontal leads Electrical alternans V1 Comment:One would be tempted to say that this trace is an exa