ECG of a patent before pulmonary embolosm
ECG of a patent before pulmonary embolosm
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ECG of a patient with secondary failure of Tricuspid Valve and Bicuspid Valve  ECG Description:   *Sinus tachycardia with a frequency of 100 per minute. *Normal electrical axis of the heart  (the maximum amount of QRS in lead II). Symptoms of Left Atrium Hypertrophy  * Double peaked  P-wave i= in lead II (P-mitrale), the distance between the "top - 40 ms; *In V1 having a second negative phase depth -0,1 mV and a duration of 40 msec. * Symptoms of hypertrophy of the prostate: * Signs of incomplete RBBB in V2 (RSr complex) * Signs of RV overload (negative T in V1-V4) *Indirect signs of right atrium hypertrophy  (the appearance of  high F-wave  in V2-V6.) *Clockwise rotation of heart - offset "transition zone" in the V6.
Pulmonary Embolism (ECG -changes )
Pulmonary Embolism (ECG -changes )
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ECG of the same patient,recorded during  sudden episodes of dyspnea , retrosternal discomfort.   ECG Description: * Sinus rhythm,  (respiratory arrhythmia), with a Heart Rate of 75-100 bpm (average - 80 .bpm ) * Electrical axis of heart deviated toward  the right (the maximum amount of QRS in lead III). *Symptoms of hypertrophy or overload of  Left Atrium . *Double humped  P- wave in lead II (P-mitrale), the distance between the "top - 40 ms; (In V1 having a second negative phase depth -0,1 mV.) *Symptoms of hypertrophy or overload PP (P-pulmonale in lead II - P amplitude greater than 2.5 mm). *Symptoms of RV hypertrophy and  overload: [Dominant R in V1-V2 (the ratio of R / S at V2-V1> 1)] [Signs of RV overload (kosoniskhodyaschy ST and negative T in V1-V4) *McGinn for signs of Wight (McGinn-White sign, symptom SI- QIII-TIII) - the appearance of S wave in 1st lead  , Q waves, and T in lead III.]  *Axis deviation to the right (in the previous ECG. Electrical axis of the heart was  normal), * increased signs of hypertrophy (in this case - an overload) of the right atrium and ventricle,  *The appearance of signs McGinn-White, together with the characteristic clinical picture, indicating a high risk of pulmonary embolism for a given patient .  * Further tactics - Urgent CT-scan of  pulmonary artery with contrast to confirm the diagnosis.
Right bundle branch block, left anterior bundle branch block, hypertrophy of RV
Right bundle branch block, left anterior bundle branch block, hypertrophy of RV
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Male, 63 years, complaints of pain in chest and heart area arising after walking 400 meters. The symptoms appeared after suffering from acute respiratory viral infection. On CVG - multivessel atherosclerotic disease with hemodynamically significant stenoses.  ECG description: Rhythm: sinus, regular; Frequency rate: 58 bpm; PQ- 0,16 sec, QRS- 0,16 sec, QT- 0,40 sec; axis deviation to the left (the angle α -400)  Right bundle branch block In leads III, V1,and V2 present QRS complex of rSR-type, M-shaped In leads  I, aVL, V5-V6 present broaden QRS,  and lead II shows broaden and notched S wave An increase in the QRS duration more than 0.12 seconds V1 lead show ST segment depression with convex, facing upward Combination with left anterior bundle branch block (left axis deviation -40o) Hypertrophy of the right ventricle myocardium (RV1˃7mm.) with its systolic overload (downslope ST depression in V2-V4)  
Core pulmonale : RAH + RVH
Core pulmonale : RAH + RVH
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ECG of a 54 year old patient , suffeing form COPD since last   20 years .    ECG Description: *Sinus rhythm, HR=, 88 beats per minute. *Electrical axis of the heart - Normal - (the maximum amount of QRS in lead II), but close to vertical (the sum of QRS in leads III and aVF of only 1 m less). *Symptoms hypertrophy PP (P-pulmonale in II, III, aVF: P amplitude greater than 2.5 mm). *Symptoms of hypertrophy of the RVH: -the ratio of R / S in V1> 1 -Signs of RV overload (negative T in V1-V3) *Signs of ischemia in the left ventricle of the side wall (horizontal ST depression in V4-V6).
Atrial fibrillation. Signs of right ventricular hypertrophy
Atrial fibrillation. Signs of right ventricular hypertrophy
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ECG patients 56 years of long-term COPD   ECG description : Non sinus rhythem with  atrial fibrillation, trachycardia  HR ≈ 130 bpm Electical exis of heart shifted to left LBBB(anterior branch). (angle α ≈ -65 °) Signs of right ventricular hypertrophy (Rv1> 7 mm, Rv1 + Sv5> 10.5 mm, the absence of S wave in V1-V2, negative T wave in the right precordial leads) We can also suspected left ventricular hypertrophy (quite pronounced R wave in the left chest leads, which are not usually characteristic of an isolated GPZH, ST-T changes in the left chest leads) RsR 'complexes at V2 probably due GPZH and suggest a slowing of the right ventricle. GPZH was confirmed by echocardiogram, it was also diagnosed with severe pulmonary hypertension
 
 
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