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It's the ECG's that george rejects that makes George's ECG's the best.
LBBB & Hyperkalæmia
Report: Junctional rhythm 57/min VEBs Left axis deviation Left bundle branch block Tall T waves consistent with hyperkalæmia Comment: The QRS narrowed to a left anterior hemiblock and the T waves normalised as potassium level came under control (Fig
P congenitale: Tetralogy of Fallot
Report:Sinus rhythm First degree AV block PR 0.24” Right atrial abnormality P congenitale (P axis +60o) Right axis deviation +125o Right bundle branch block Right ventricular hypertrophy Comment:In P congenitale the atrial wave is quite large in
LVH – Volume Overload Pattern
Report:Sinus rhythm 65/min Left atrial abnormality Left ventricular hypertrophy, volume overload pattern RSR’ in V1-2 Comment:The LAA is best seen in V3-5, along with prominent T waves. With LVH voltage in the chest leads this constitutes evidence for
Movement Artefact Simulating VEBs
Report:Sinus rhythm 80/min Within normal limits Movement artefact in simultaneous V4-6 & V1 strip Comment:The computer diagnosed a (single) VEB. If there were a single VEB, it would have been about 0.56” in duration! It is easy to see, once thought of
Hyperkalæmia
Report:Sinus rhythm 89/min Borderline first degree AV block PR interval 0.20” Right axis deviation +140o Intraventricular conduction delay QRS 0.13” Peaked T waves c/c hyperkalæmia Comment:All the T waves (even the inverted ones) are peaked, but th
Traumatic Pericarditis
Report:Sinus rhythm 92/min Diffuse ST segment elevation c/c pericarditis Comment:The ST elevation is diffuse, reflecting a hæmopericardium rather than diffuse injury. There are also narrow Q waves in multiple leads, in this case a normal variant. A tra
Acute Cor Pulmonale
Report: Sinus rhythm S1Q3T3 (McGinn-White) pattern Anteroseptal T wave inversion consistent with right ventricular strain Comment: Tachycardia is not invariably present, especially with massive or submassive embolisation. This patient, like many others
Myxœdema Diagnosed on ECG
Report:Sinus rhythm 92/min Low voltage throughout (absolute small voltage)[! XE "Low voltage" \t "See Small voltage" !] Prolonged QT interval 0.40” QTc 0.48’ Diffuse nonspecific T wave changes Comment:The patient was quite distressed post-laparotomy
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
Noonan’s Syndrome
Report:Sinus rhythm 119/min Right axis deviation ± 180o Right ventricular hypertrophy voltage R/S < 1.2 in V6 (1 month – 15 yrs) Right ventricular hypertrophy T wave criterion Upright TV1 (5 days – 4 yrs) Probable right ventricular hypertrophy Comm