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It's the ECG's that george rejects that makes George's ECG's the best.
Romano-Ward Syndrome
Report: Sinus rhythm 54 - 64/min Prolonged QT interval 0.56” Upper limit of normal for rate 57/min 0.41” Comment: The only abnormality is the long QT interval. The Romano121-Ward122 syndrome is similar to Jervell and Lange-Nielsen syndrome123, but ther
Tape Speed Artefact
Report: Normal sinus rhythm Speed artefact Comment: Speeding up the tape has the same effect on the trace as slowing down the paper speed during a recording. The Cardiologist operating the Holter did this deliberately for my benefit, in 1976. I was take
Dextrocardia with RBBB
Report: Sinus rhythm Mirror-image dextrocardia Right bundle branch block Nonspecific ST/T changes Comment: The precordial sequence gives the diagnosis. In the (much commoner) situation of technical arms’ lead reversal153, the V leads are unaffected.
Juvenile Notch
Report: Sinus rhythm Axis +90o Early transition Normal trace Juvenile notch Comment: The interesting part of the ECG are leads V2 and V3, where a prominent juvenile notch of the T wave mimics 2:1 AV block. If only these two leads were available, it w
Mitral Stenosis
Report:Sinus rhythm 99/min Right axis deviation +125o Late transition (clockwise rotation) Left atrial abnormality Small voltage in frontal leads Comment:The combination of LAA and presumptive RVH (from RAD and clockwise rotation) is suggestive of mi
Brain Waves
Report: Sinus rhythm 90/min Prominent T waves Prolonged QT interval Comment: The patient became brain dead soon after this trace was taken, from a massive subarachnoid hæmorrhage. The “cerebral” repolarisation changes are most specific with giant T wav
Atrial Fibrillation in Hypothermia
Report: Atrial fibrillation with average ventricular response 97/min J (Osborn) waves suggest hypothermia Prolonged QT interval Comment: AF is the commonest arrhythmia in hypothermia, seen in about 50% patients. In Woden Valley Hospital (and in this Li
Mixed Mitral Valve Disease
Report:Sinus rhythm 55/min SVEB, LBBB aberrancy Left atrial abnormality Borderline right axis deviation +90o Borderline low voltage in frontal leads LVH voltage chest leads Nonspecific ST/T changes Comment:The picture would be that of mitral stenos
Left Ventricular Diastolic (Volume) Overload
Report:Sinus rhythm Left atrial abnormality First degree AV block Early transition Left ventricular hypertrophy, volume overload type Comment:The upright T waves tend to remain upright for a long time on volume overload LVH; eventually they come down
Axis Illusion in Emphysema
Report:Sinus tachycardia 110/min Right atrial abnormality P axis +85o Left axis deviation QRS –90o Late (or no) transition Comment:An immediate clue that the LAD is not due to an LAHB (its commonest cause, overall) is that S2 > S3, opposite of wha