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It's the ECG's that george rejects that makes George's ECG's the best.
Pulmonary Embolism: Discrete S1Q3T3 Pattern
Report:Sinus tachycardia 111/min Borderline trace, probably normal Comment:Much depends what one is looking for. I countersigned the Registrar’s and the computer report of “otherwise normal ECG” during routine reporting, but the patient arrived to my IC
Hypothermia Without Bradycardia
Report: Sinus rhythm 76/min Left axis deviation – 35o Intraventricular conduction delay (IVCD) QRS 0.14”) J (Osborn) waves (hypothermic humps) Nonspecific ST/T changes Prolonged QT interval QTc 0.50” Comment: The core temperature was 31oC. The rat
Carney’s Syndrome
Report:Sinus rhythm 84/min Right axis deviation +100o Left atrial abnormality RSR’ in V2 Late transition Comment:The trace suggests mitral stenosis. She had it, but not an ordinary one: it was caused by a large atrial myxoma. In her case, part of Car
Myocarditis
Report: Sinus rhythm 88/min Prolonged QT interval QTc 0.50” Diffuse T wave inversion Comment: T wave changes, by themselves, are virtually never diagnostic of anything. In this setting, they are consistent with myocarditis or ischæmia. They are deeper
A Sticky Roller
Report: Sinus rhythm Right bundle branch block Paper speed artefact Comment: The immediate action would be to check the paper path of the monitor’s writer. Note how, in some of the distorted beats, the T waves are unaffected: it all depends on timing.
Hypercalcæmia
Report: Sinus tachycardia 113/min Borderline left ventricular hypertrophy voltage Short QT interval consistent with hypercalcæmia QT = 0.28” QTc = 0.34” Comment: The ECG is not a very good guide to the degree of hypercalcæmia; this is hardly surprisin
Dextrocardia & IVCD
Report:Atrial fibrillation with ventricular response approx 112/min Intraventricular conduction defect QRS 0.15” Lead misplacement or dextrocardia Comment:The patient had Poland’s syndrome51 with dextrocardia and a mild Ebstein’s anomaly; the former i
VEBs & U Waves: Hypokalæmia
ReportSinus rhythm. Sinus arrhythmia. VEBs, bigeminy. Prominent U waves consistent with hypokalæmia. Comment:The ECG monitor alarmed at the heart rate 34/min. This need not be merely spurious bradycardia, a mistake in the first place, due to negative
Physiotherapy of Tetanus
Report:Sinus tachycardia Movement artefact (middle strip) Comment:The QRSs can be mapped out throughout the period of vibration physiotherapy - a familiar artefact in all the ICU units. A tetanic spasm would not be very different, but the patient should
Hypokalæmia, pre-VF
Report:Sinus rhythm Right atrial abnormality Poor R wave progression Probable left ventricular hypertrophy Nonspecific ST/T changes Prolonged QT interval ? large U waves Somatic tremor Comment:Potassium was 2.0 mEq/L and the pH 7.66. Most patients