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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
Ostium Primum ASD
Report:Sinus tachycardia 137/min (up to 133/min normal for below 4 years) Left axis deviation â60o Possible RVH (5mm R wave in V1 after 6 months of age) Comment:The rRâ in V1 is consistent with but not diagnostic of RVH: it can always be an RSRâ
Emphysema: α-1 Antitrypsin Deficiency
Report: Sinus rhythm Left axis deviation â 80o Comment: The commonest cause of LAD is LAHB; in middle-aged men, the commonest cause of LAHB is underlying coronary disease, often subclinical. This trace looks like LAHB, down to QR in aVR and RS in V6.
Tricuspid Atresia
Report: Atrial tachycardia 150/min, variable block Ventriculophasic effect Left axis deviation â35o Nonspecific ST/T changes Prolonged QT interval Comment: The P waves are very broad and widely notched, like the sinus P waves (Fig 150a below). Both
Paced Tricuspid Atresia
Report:Atrial pacemaker rhythm 111/min Left axis deviation â60o Left ventricular hypertrophy with ST/T changes Comment:The child had Fontan repair119 (atriopulmonary connection) in infancy. His combination of LVH and LAD is characteristic of tricus
Unread Pre-Discharge ECG
Report: Sinus rhythm 58/min Left axis deviation - 50o Intraventricular conduction defect (IVCD) Probably LAHB + non-specific conduction delay Possible LVH Giant anteroseptal T wave inversion Prolonged QT interval 0.660â (QTc for 58/min 0.45â)
Axis Illusion in Emphysema
Report:Sinus tachycardia 110/min Right atrial abnormality P axis +85o Left axis deviation QRS â90o Late (or no) transition Comment:An immediate clue that the LAD is not due to an LAHB (its commonest cause, overall) is that S2 > S3, opposite of w
Endocardial Cushion Defect & Biventricular Hypertrophy
Report:Sinus rhythm 63/min First degree AV block PR 0.22â Right atrial abnormality Left anterior hemiblock LAD â65o RSRâ in V1 Biventricular hypertrophy Katz-Wachtel phenomenon: QRS 67 mm in V4 Nonspecific ST/T changes Comment:The interes
Emphysema: Left Axis Deviation
Report:Sinus tachycardia Right atrial abnormality Left axis deviation â40o Possible old anterior infarction Suggestive of emphysema Comment:Characteristically, S2 > S3 in LAD due to emphysema vis à vis LAHB. Some argue this is not a true LAD but a
Pædiatric LAD & LVH: Tricuspid Atresia
Report:Sinus rhythm 160/min Right atrial abnormality, P congenitale type Left axis deviation â30o (for age: 0o - -90o) Left ventricular hypertrophy Comment:The infant had a systemic-pulmonary artery shunt and was doing well clinically. The striking
Endocardial Cushion Defect
Report:Sinus rhythm Borderline left atrial abnormality First degree AV block PR 0.26â Left axis deviation â 90o Right ventricular hypertrophy Possible left ventricular (â´biventricular) hypertrophy Comment:This is another RVH, but with an LAD