The TUP phenomenon

Report:

Sinus tachycardia 107/min

Borderline left axis deviation – 30o

Nonspecific ST/T changes

Prominent U wave

Comment:

The inferior leads show it well. If Marriott had not dignified it with a (however jocular) name105, it probably would not be here.

The T-U-P waves may, in some leads, have similar magnitude and mime atrial flutter. It is one of the (many) reasons why 12-lead ECG should always be available in preference to a single-lead rhythm strip.

It is, of course, possible to make a diagnosis from a single lead, but it would be like an ophthalmologist pronouncing on an undilated eye!

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