ECG

Question 1

What is the abnormality here?

Answer 1

ventricular tachycardia

—regular broad complex tachycardiac indicating a likely ventricular origin for the rhythm.

Question 2

What is the abnormality here?

Answer 2

pulmonary hypertension after eg PE

• • Right axis deviation (QRS more negative than positive in lead I);
• • Positive QRS complexes (‘dominant R waves’) in V1 and V2 suggesting right ventricular hypertrophy; •
• ST depression and T-wave inversion in the right precordial leads (V1–3) suggesting right ventricular strain; •
• Peaked P waves (P pulmonale) suggesting right atrial hypertrophy.

Question 3

Whta is teh abnormality here?

Answer 3

anterior MI

Acute anterior myocardial infarction—ST segment elevation and evolving Q waves (the fi rst QRS defl ection is negative) in leads V1–4

Question 4

WHat is the abnormality here?

Answer 4

Acute infero-lateral myocardial infarction:

marked ST elevation in the inferior leads (II, III, aVF), but also in V 5 and V 6, indicating lateral involvement. There is a ‘reciprocal change’ of ST-segment depression in leads I and aVL; this is often seen with a large inferior myocardial infarction.

Question 5

what is the abnormality here?

Answer 5

Right bundle branch block —broad QRS, M pattern in V 1 and sloped S wave (with the eye of faith, a ‘ W’ shape) in V 5. M aRR o W = RBBB

Question 6

What is the abnormality here?

Answer 6

Left bundle branch block: wide QRS with a W pattern in V1 (slight notching in upstroke of S wave—clearer in V3) and the M pattern in V6. WiLLiaM = LBBB.