Recording artifact in Parkinson's disease
Recording artifact in Parkinson's disease
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ECG of a patient with Parkinson's disease, mistakenly interpret by district therapist as "atrial fibrillation".  ECG description:  Sinus rhythm, regular(P wave is visible before each QRS complex in leads III and V1) Horizontal axis (the maximum amount of QRS - in lead I) Indirect signs of hypertrophy of the LV(in lead V1, P wave is in negative phase with duration of 40 msec and depth of 0.1 mV).   This ECG was mistakenly interpreted as atrial fibrillation (or atrial flutter) due to large rhythmic waves(such as F or f) in leads I, II, aVR, aVF at 300 min. In fact, in lead III, recorded in sync with other standard leads, there is a normal R wave.   Such an artifact formed due to the rhythmic swaying of patient's right hand due to parkinson's disease, near which red electrode was placed. Therefore, the "wave of atrial fibrillation" is best seen in I, II and aVR leads, shot with red electrode.   The ECG of the same patient, taken with a fixed hand, there were no additional waves.  
Artifact record pretending to ventricular fibrillation or flutter
Artifact record pretending to ventricular fibrillation or flutter
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ECG, recorded with poor electrode contact and simulating ventricular fibrillation or flutter ECG description: To interpret such an ECG is impossible, because Looking at the first three standard leads we can assume the presence of ventricular fibrillation in the patient, and assessing the chest leads which clearly shows distinguishable regular QRS complexes on the back of strong electrical noise. Conclusion: The low-quality ECG, should be recorded again.   After seeing the beginning of ECG tape recording deck, nurse immediately call a doctor, a patient suspected development of ventricular fibrillation. However, the error lay in the recording procedure - nurse in a hurry forgot to smear the electrodes and the patient's skin with soap and water. Poor contact with the skin has led to the emergence of such interference.  
ECG after resection of the lower lobe of the left lung
ECG after resection of the lower lobe of the left lung
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ECG of a young patient who had undergone resection of the lower lobe of the left lung after being stabbed.    ECG Description:  Sinus rhythm, 50 bpm  (sinus bradycardia)  Left  deviation of electrical axis of heart  (the maximum amount of a positive QRS in lead  I (9mm) and  in  lead aVL (7mm)  .  High R in the V4-V6, reaching 40mm. This is due to the anatomical proximity of  myocardium to  chest electrodes .  After resection of lower lobe of left lung arisen an empty area at the site of resection.  So heart changed it's position and shifted in that empty area of resucted lobe ." This situation  reduced the distance from the electrodes and myocardiam  and changed  the electrical axis of the heart more toward left .
Артефакт записи: ложное возникновение изолинии
Артефакт записи: ложное возникновение изолинии
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ЭКГ пациента, направленного на консультацию к кардиологу с диагнозом "СА-блокада 2 степени." На самом деле на ЭКГ - типичное ложное возникновение изолинии из-за плохого контакта электродов с кожей. Некоторые аппараты в момент возникновения сильной помехи блокируют запись, и на ЭКГ вместо хаотичных линий регистрируется отсутствие какой-либо электрической активности. Другая возможная причина - поломка аппарата и блокирование записи даже в нормальных условиях. Как понять что это артефакт, а не пропущенные сокращения? Вместо пропущенных сокращений записана абсолютно ровная изолиния, даже без мелкого электрического шума, которые есть в момент записи комплексов (на схеме внизу отмечены стрелками) Перед третьим и четвертым QRS зарегистрированы волны Т, - но перед ними нет комплексов QRS! Волна Т последнего сокращения как-бы "обрезана" внезапным началом изолинии (отмечено стрелкой) После повторной регистрации ЭКГ на другом ЭКГ-аппарате у больного зафиксирован синусовый ритм с частыми суправентрикулярными экстрасистолами. Никаких пауз.
 
 
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