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It's the ECG's that george rejects that makes George's ECG's the best.
Status Asthmaticus
Report: Sinus tachycardia Right axis deviation +120o Clockwise rotation Comment: Right axis deviation may still be a normal variant in a young subject; in this case we can be sure it was a result of cor pulmonale as the axis normalised with clinical im
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
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-day
Hyperkalæmia
Report:Sinus rhythm 94/min Intraventricular conduction delay (IVCD) QRS 0.14” Peaked T waves, possible hyperkalæmia Comment:Patients arresting in dialysis units are invariably treated for hyperkalæmia. On arrival to ICU, the potassium level was only 7
Myocardial Infarction and Cerebral Hæmorrhage
Report: Sinus tachycardia Left anterior hemiblock Left ventricular hypertrophy Acute anterior infarction Comment: The pattern is indistinguishable from that of acute myocardial infarction. There was, however, no other evidence for it, in life or at au
Peyronie's Disease of the Heart
Report: Peyronie's disease196 of the ECG machine. Comment: The characteristic curvature is seen not only on the patient's complexes, but also on the machine standardisation artefact. The problem was a displaced heated stylus on an older ECG machinemode
Global T Wave Inversion
Report: Sinus rhythm 65/min Global T wave inversion Prolonged QT interval 0.52” QTc for 65/min = 0.42” Comment: This healthy young woman arrested after administration of cocaine paste to the nose and injection of ‘some’ 1:200,000 adrenaline, during GA
Two Movement Artefacts
Report:Sinus rhythm 81/min Nonspecific ST/T changes Movement artefact Comment:The wobbly crinkled baseline in the first set of leads is due to movement but does not deserve a mention because it does not distort the trace much. In V6, however, there is
Faulty Calibration
Report: Sinus rhythm Faulty standardisation (upper left-hand corner) Sloping ST segment depression probably due to faulty standardisation Comment: The repeat trace in the CCU was completely normal (Fig 201a below). Instead of receiving an apology and
Atrial Septal Defect
Report:Sinus rhythm 94/min RSR’ in V1 Right precordial ST segment depression Comment: Over 90% of ASDs have an RSR’ pattern in V1; in time, this tends to became a proper RBBB. This is not of great diagnostic value, except when absent, in an ASD suspec