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It's the ECG's that george rejects that makes George's ECG's the best.
SVT: Pre-existing RBBB/LAHB
Report: Tachycardia 102/min ? origin Onset of supraventricular tachycardia 190/min Right bundle branch block Left anterior hemiblock Anterior infarction, probably old Comment: Frontal plane axis of –90o and the monophasic R wave in V1 bode ill for th
Masquerading Bundle Branch Block: Positive Concordant Precordial Pattern
Report:Atrial fibrillation with rapid ventricular response Left anterior hemiblock Right bundle branch block Masquerading (standard + precordial) bundle branch block Anterior infarction, probably old Comment:This is a case of RBBB with high-grade LAH
Ventricular Tachycardia Rightly (Mis)diagnosed
Report:Ventricular tachycardia 170/min Comment:There is nothing against the diagnosis of VT in this trace, and a lot in its favour: monophasic R waves in V1 with left rabbit ear taller than the right and QRS duration over 0.14” (in basic RBBB morphology)
RBBB as Monophasic R wave in V1
Report:Sinus rhythm 94/min Left anterior hemiblock QRS axis –40o Right bundle branch block Comment:RBBB can be manifest as pure R wave in V1, especially in the presence of a hemiblock. One could not, without a baseline trace in sinus rhythm, diagnose
Alternating (2:1) Right Bundle Branch Block
Report: Sinus tachycardia 126/min Left anterior hemiblock Frontal plane axis –60o Alternating right bundle branch block Poor R wave progression Nonspecific ST/T changes Comment: The diagnosis depends, critically, on identical PR interval in all the
Alternating Left Anterior Hemiblock
Report:Sinus tachycardia 102/min Alternating LAD, probably LAHB Acute or recent anterior infarction Comment:The presenting symptoms of both angina and infarction are often atypical in women5. This patient had post-infarction angina at the time of this
Inferior Infarction and Left Anterior Hemiblock
Report:Sinus rhythm 78/min Left axis deviation – 72o Left anterior hemiblock Old inferior infarction Clockwise rotation (late transition) Comment:The LAHB is seen as inferior QS waves > 5 mm in depth, lack of secondary R waves in the inferior leads a
Old Posterior and New Inferior Infarct
Report:Sinus rhythm 57/min Left axis deviation Posterior infarction, old Recent or acute inferior infarction Comment:Strictly speaking, the report should have said: inferoposterior MI, ?age. The patient had a known posterior infarction and left anter
Old Anteroseptal MI & BBBB
Report:Atrial fibrillation with rapid response 160/mi9n Right bundle branch block Left anterior hemiblock Standard masquerading bundle branch block Old anteroseptal infarction Comment:In 1 and aVL the QRS resembles LBBB rather than RBBB, a situation
LVH & RBBB
Report:Sinus rhythm 78/min Left atrial abnormality Third degree AV block Ventriculophasic sinus arrhythmia Junctional rhythm 42/min Right bundle branch block Left anterior hemiblock Frontal axis – 40o Left ventricular hypertrophy with ST/T changes