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SOME PATHOLOGICAL ECG'S        

 
     

PREEXCITATION

CONDUCTION

HYPERTROPHY

INFARCTIONS

RYTHM

VARIA

NORMAL ECG'S


PREEXCITATION

WOLF-PARKINSON-WHITE TYPE I

 Short PR interval, positiv delta wave in V1

WPW I example 1                   PDF  

WPW I example 2                   PDF

WPW I example 3                   PDF


WOLF-PARKINSON-WHITE TYPE II

 Short PR interval, negativ delta wave in V1.

WPW II example 1               PDF

WPW II example 2                PDF

WPW II example 3                PDF

WPW II example 4                PDF

WPW II example 5 

 


CONDUCTION

Incomplete right bundle branch block (RBBB)

Example

 Complete right bundle branch block (RBBB)

Example 1           Example 2         Example 3           Example 4

Example 5 (also AV block degre I)  Example 6 ( also RAH)  

 PDF example

Complete left bundle branch block (LBBB)

Example 1             Example 2        Example 3           Example 4

Example 5             Example 6         Example 7           Example 8 ( + LAH) 

PDF example      PDF example      PDF example  

Left anterior hemiblock (LAHB)

Example 1

Example 2 also possible anterior ischaemie(coronary by pass 18 years ago ) 

Left posterior hemiblock (LPHB)

Example              PDF example

Right bundle branch block + Left anterior hemiblock

Example 1           Example 2 ( + AV Block  I)      Example 3         

PDF example 1       PDF example 2

Right bundle branch block + Left posterior hemiblock

Example 1                   PDF example

HYPERTROPHY

Right atrial hypertrophy (RAH)

Example 1                Example 2       Example 3 (also RVH)     Example 4 (also RVH)

Example 5 (also RVH)  Example 6 (also RVH)

PDF example 1

Left atrial hypertrophy(LAH)

Example 1 (also LVH)          Example 2 (also LVH ( R>13 mm in AVL ) en AV Block I)

Example 3 (also pathological LVH)

Biatriale hypertrophy (BAH)

Example 1 (also LVH)           Example 2 (also RVH)

PDF example 1          PDF example 2         PDF example 3

Right ventricular hypertrophy (RVH)

Example 1 (also RAH)    Example 2 (also RAH)        Example 3 (also RAH)

Example 4 (also RAH)     Example 5 (also BAH)        Example 6 (cor pulmonale)

PDF example 1       PDF example 2         PDF example 3

Left ventricular hypertrophy (LVH)

Example 1          Example 2          Example 3 (also LAH)

Example 4 (Pathological LVH)

Example 5 (Fysiological LVH)

Example 6 (possible ischaemia)

Example 7 ( R>13 mm in AVL,also LAH and AV Block I)

Example 8 (also LAH)

Example 9 (Pathological LVH)

Example 10 (Pathological LVH)

Example 11 (Pathological LVH, also biatrial hypertrophy)

Example 12 (Pathological LVH)

PDF example 1                 PDF example 2              PDF example 3

Biventricular hypertrophy (BVH)

Example 1also LAH

Example 2 LVH : R in AVL>13 mm  RVH : postive QRS in V1 en R<S in V6.


PDF example

INFARCTIONS

ANTERIOR INFARCTIONS

example 1  Recent anterior infarction ( QS waves V1 at V4 ) and LAHB.

example 2 Old anterior infarction and bifascicular block (RBBB and LAHB )     PDF

example 3 Recent anterior and lateral infarction. PDF

example 4 Acute anterior infarction.                      PDF

example 5 Acute anterior infarction and left anterior hemiblock.    PDF

example 6 Hyperacute phase. Symmetrical, small and high T waves V1 V2 V3   PDF

example 7 Anterior infarction and LAHB.             PDF

example 8 QS waves V1 V2 V3. Old anterior infarction + possible aneurysm      PDF

example 9 Acute anterior infarction.                      PDF

example 10 Acute anterior infarction

example 11 Anterior infarction ( 5 days old )

example 12 Old anterior infarction with possible aneurysm.

 


PDF example  Old anterior infarction ( 5 year )

PDF example   Acut anteroseptal infarction

PDF example   Old anterior infarction.

INFERIOR INFARCTIONS

example 1 Old inferior infarction + anterior ischaemia.

example 2 Also old anterior infarction, ischaemia and conduction delay.

example 3 7 days old. Also slow R progression precordial.

example 4 Acute phase.                    PDF

example 5 Also AV block first degre and digitalis impregnation.        PDF

example 6 Old inferior infarction       PDF

example 7 Old inferior infarction and LAHB.                                       PDF

example 8 Old inferior infarction and LGL syndrom (PQ 86 ms )       PDF

example 9 Inferior infarction, poor repolarisation anterolateral.

example 10 Old inferior infarction.

example 11 Recent. Also LVH          PDF

example 12 Old inferior infarction.

example 13 Old inferior infarction.

example 14 Old inferior infarction with possible anterior ischaemia.


PDF example

PDF example    Old inferior infarction with LVH

PDF example    Inferior infarction after 3 weeks

POSTERIOR INFARCTIONS

example 1  R wave and positiv T wave  in V1.                  PDF

example 2  R wave and positiv T wave in V1. Also anterior ischaemia ( AVL ).   PDF

example 3  Also LAH and anterior infarction.                   PDF

COMBINATIONS OF INFARCTIONS AND OTHER PATHOLOGY

Anterior and inferior infarction Q waves in D2, D3 and AVF. Pardee waves V1 at V5.

Old anterior and inferior infarction Q waves D3, AVF, V1 and V2.                PDF

Recent extensiv anterior and septal infarction                                                 PDF

Old inferior infarction, LAH ( left atrial hypertrophy) and LAHB ( left anterior hemiblock )

Old inferior infarction and complete RBBB( right bundle branch block).         PDF

Acute lateral infarction  Pardee waves in D1 and AVL.                                  PDF

Acute subendocardial infarction Negativ T waves V4 at V6.                           PDF

Old anterior infarction and LAHB Possible anterior wall aneurysm.               PDF

Old anteroseptal infarction and LAHB  Possible anterior wall aneurysm.       PDF

Old inferior infarction, atrial fibrillation and LVH                                             PDF

Old anterior infarction and complete RBBB small Q waves in V2 and V3.      PDF

Extensiv anteroseptal infarction

Old inferior and recent anterior infarction  Q wave  in V4 and V5                    PDF

Old inferior and recent extensiv anterior infarction  Q waves V1 at V5. Enlarged QRS complex.  PDF

Old anterior and old inferior infarction                                                               PDF

Old anterior and old inferior infarction  Possible anterior wall aneurysm        PDF  

Old anterior and old inferior infarction  Possible anterior wall aneurysm.      PDF

Old anterior, old inferior infarction, complete RBBB and LAH.

Subarachnoidal aneurysm  Inverted and deep T waves in the precordal leads.    PDF


RYTHM

Sinusale tachycardy

Example  140/ minute, child 4 years with agitation.       PDF

Atrial flutter.

Example 1   conduction 1/1      PDF

Example 2   conduction 2/1      PDF

Atrioventricular reentry tachycardy (AVRT).

Example 1   200 milliseconds after the narrow QRS complexes, retrograde P wave is visible. This " Coumel P" waves are the result of retrograde conduction.      PDF

Example 2  140 milliseconds after the narrow QRS complexes, retrograde P wave is visible. Circular AV tachycardy with fast extra conduction.                       PDF

Atrioventricular nodal reentry tachycardy (AVNRT)

Example 1   Retrograde P waves immediately after the QRS complex.   PDF

Supraventricular tachycardy with LBBB.

Example           PDF

Supraventricular tachycardy with RBBB

Example           PDF

Ventricular extrasystole

Example  also left axis QRS and flat repolarisation     PDF

Ventricular tachycardy

Example 1  Fascicular tachycardy. Only slightly enlarged QRS complex ( 136 ms )  QRS axis is right and high. V1 and V2 : right bundle branch block . THIS IS A VENTRICULAR TACHYCARDY !  The origin is in the inferoposterior fascicle of the left bundle.      PDF

Example 2  Only moderate QRS enlargment. VENTRICULAR (!) TACHYCARDY originating in the left anterior fascicle of the left bundle.                 PDF

Example 3             Example 4                Example 5             Example 6

PDF                          PDF                           PDF                        PDF


VARIA:

Hypokalaemia

Example 1

Example 2  also LVH                        PDF example

Hyperkalaemia

Example  severe hyperkalaemia        PDF example 

Hypocalcaemia

Example                     PDF example.

Hypercalcaemia

Example                     PDF example 

Acute pericarditis

Example 1                        Example 2  microvoltage                 Example 3  

PDF example 1                PDF example 2                                 PDF example 3

Technical dextrocardia

Example  Electrodes for right and left  arm are interchanged accidentely : D1 is oppposite to V6.

PDF example 

Brugada syndrom

PDF example

Hypothyroidia

Example

Cardiomyopathia

Example ischaemic cardiomyopathia

Example hypertrofic apical cardiomyopathia

PDF example 

Ischaemia- Angor

Example 1  Patient with coronary bypass operation

Example 2  Possible ischaemia

Example 3  Very suspected for ischaemia, also sinusale tachycardia

Example 4   Very suspected for ischaemia

Example 5  ECG recorded during attack of angor pectoris

PDF example 5

Acute pulmonar embolism

Example 1  RVH

Example 2  RVH + S1 Q3 waves.

PDF example 1                PDF example 2

Digitalis

Example of digitalis impregnation PDF example

Pacemaker

Example  of right ventricular pacemaker.

PDF example

SOME NORMAL ECG'S:

Normal Ecg's or traces with a moderate abnormality may differ, therefore you see some normal or borderline normal PDF traces here

Example 1 PDF       Example 2 PDF        Example 3 PDF       Example 4 PDF   

Example 5 PDF       Example 6 PDF       Example 7 PDF       Example 8 PDF 

Example 9 PDF       Example 10 PDF      Example 11 PDF


Auteur: Dr. Ganseman Jose

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