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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Agonal Rhythm
Report:Pacemaker rhythm 60/min 2 Absolute small voltage 3 Probable acute anterior infarction 5 Comment:There is probably an atrial standstill. The patient sustained clinical acute infarction and cardiogenic shock, dying within minutes of this trace b
Absolute Small Voltage & Its Commonest Cause
Report:Sinus rhythm 77/min Absolute small voltage Anterior infarction, age indeterminate Comment:This patient, too, had history of a remote infarction; like the previous case, he too could have a ventricular aneurysm. He was asymptomatic and there was
Pericardial Tamponade: Electrical Alternans
Report:Sinus tachycardia 111/min Small voltage Electrical alternans Comment:Alternate QRS complexes vary in size, in this case due to the heart swinging in the pericardial sac. There is no mechanical counterpart, but there may be alternation of the hea
Acute Cor Pulmonale
Report: Supraventricular tachycardia, probably sinus, 160/min Right axis deviation +95o Small voltage Right bundle branch block Borderline T wave changes Comment: The rhythm strip from a later trace is superimposed over the original one to show the p
Small Voltage in Anasarca
Report: Sinus rhythm 98/min Absolute small voltage Diffuse nonspecific ST/T changes Prolonged QT interval Comment: The entire QRS complex is less than 5 mm in the frontal leads and less than 8 mm in the precordial leads. The commonest cause is extensi
Absolute Small Voltage
Report: Sinus rhythm Absolute small voltage Poor R wave progression Nonspecific ST/T changes Comment: The QRS amplitude is less than 0.5 mV (5 mm) in all the frontal plane leads and less than 1.0 mV in all the chest leads. The patient had been off st
Left Pneumonectomy Pseudoinfarction
Report:Sinus rhythm 62/min Right axis deviation +135o Possible anterior infarction ?age Possible cor pulmonale Small voltage, chest leads Comment:The preoperative ECG was normal (Fig 15a below). The obvious question is whether a perioperative event l
MyxÅdema
Report: Sinus rhythm 67/min PR interval 0.22â Small voltage, frontal leads Borderline QT prolongation Comment: This is a rather unremarkable trace. The patient, however, had severe myxoedema, bordering on coma. One should not look to ECG for signs o
COAD: P Pulmonale Causing ST Segment Depression
Report: Sinus tachycardia 117/min Right atrial abnormality Small voltage (absolute) Late transition Borderline ST segment changes Comment: The P wave axis is 86o, with 0.4 mV amplitude in lead 2 and the characteristic peaked shape. As often happens
True Alternans in Cardiac Tamponade
Report:Sinus tachycardia 126 - 132/min Electrical alternans Comment:By definition, there must be no change in rhythm or conduction for alternans to be diagnosed. In this case, the mechanism is the "swinging" of the heart, pendulum-like, within the peric