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Search and discover over 2,500 ECG reports written by cardiologist and intensivist Dr George Nikolić OAM.
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
Another Isolated U Wave Inversion
Report:Sinus rhythm 95/min Right atrial abnormality (RAA) Probable LVH with ST/T changes Inverted U waves c/w ischæmia Movement artefact V5. Comment:This patient, with chronic emphysema and hypertension, had an episode of chest pain two years previo
Negative T & U Waves
Report:Sinus rhythm 78/min Diffuse nonspecific ST/T changes Prominent U waves ?hypokalæmia Comment:U wave polarity follows that of the preceding T wave, except in ischæmia, where isolated U negativity may be a marker of critical LAD artery lesions. I
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
Hypokalæmia
Report:Sinus rhythm. Borderline left axis deviation -30o. Prominent repolarisation changes suggestive of hypokalæmia. Comment:The patient had severe metabolic acidosis and marked, paralysing hypokalæmia (K 1.7 mEq/L) No cause was found during her 4-d
VEBs & U Waves: Hypokalæmia
ReportSinus rhythm. Sinus arrhythmia. VEBs, bigeminy. Prominent U waves consistent with hypokalæmia. Comment:The ECG monitor alarmed at the heart rate 34/min. This need not be merely spurious bradycardia, a mistake in the first place, due to negative
LVH with ST/T Changes
Report:Sinus bradycardia 49/min Left atrial abnormality Left ventricular hypertrophy with ST/T changes Comment:There are typical repolarisation changes in all the leads; the voltage criteria offer an embarrassment of riches. The LAA is part of LVH cri
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
Hypokalæmia - Giant U Waves
Report:Sinus rhythm 52/min Borderline right axis deviation +91o Right atrial abnormality Late transition Prolonged QT (QU) interval 0.72â Comment:It would not be possible to tell whether the apparent QT prolongation is due to a large U wave that ha
Hypokalæmia: Helmet-Like TU Waves
Report:Sinus rhythm 96/min TU waves c/c hypokalæmia Comment:The appearance of rounded TU waves in the inferior leads is very characteristic, often leading to a spot diagnosis. This ECG is made easier by the helpful separation of T and U waves in the pr