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It's the ECG's that george rejects that makes George's ECG's the best.
RVH in COAD
Report: Atrial fibrillation, mean ventricular rate 85/min Right axis deviation + 130o qRV1, probable right ventricular hypertrophy Nonspecific ST/T changes Comment: RVH is seldom expressed as dominant R wave in V1 in COAD; the commonest change is RAD
Brugada Morphology
Report:Sinus rhythm 80/min Left axis deviation – 35o Nonspecific T wave changes 3, aVF, V5-6 V1-2 ST elevation c/c Brugada’s syndrome Comment: This is a not infrequent problem in Casualty (see also Case 17): what to do with a patient whose ECG has a
Electromechanical Association: Spurious VT
Report:Sinus tachycardia. Incomplete RBBB. Movement artefact. Comment:The movement artefact occurs at the same rate as the pulse. The patient had a forceful precordial impulse, which visibly moved the lead attachment. I could not reproduce the original
Idioventricular Rhythm Mime of RVH
Report:Idioventricular (?fascicular) rhythm 57/min Giant T wave inversion Prolonged QT interval Comment:The QRS morphology suggests, superficially, RVH. In V1, however, it is not a true qR complex – there is a small primary R wave as well: it’s an rsR’
Horizontal Heart
Report: Sinus rhythm Normal axis (-14o) Horizontal heart position Late transition ECG within normal limits Comment: The electrical heart position is defined by leads aVL and aVF alone; the term is a descriptive one, only useful if there is no abnorma
Problems with Lead 2
Report:Atrial fibrillation with rapid ventricular response 127/min Intermittent (rate-dependent) right bundle branch block Nonspecific ST/T changes Comment:The L2 rhythm strip demonstrates that this lead is one of the worst (in this case, the worst) to
COAD: P Pulmonale Causing ST Segment Depression
Report: Sinus tachycardia 117/min Right atrial abnormality Small voltage (absolute) Late transition Borderline ST segment changes Comment: The P wave axis is 86o, with 0.4 mV amplitude in lead 2 and the characteristic peaked shape. As often happens
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 pre
Early Repolarisation in Inferior Leads
Report:Sinus rhythm 66/min Inferior ST segment elevation LVH voltage Comment:The unusual elevation is confined to the inferior leads. The slight one in V1-2 is normal. There is also some 0.5 mm depression in aVL, but true reciprocal changes are usually
Absolute Small Voltage
Report:Supraventricular tachycardia, possibly sinus, 146/min Absolute small voltage QRS < 5 mm frontal, < 10 mm chest leads Diffuse ST segment depression c/c infarction/ischæmia Comment:Some of the best examples of “ischæmic” ST segment depression com