Pin pointing the pathway !

I’m sure that for many budding cardiologists including me, diagnosing accessory pathway based on surface ECG has been herculean task. Neverthless i have seen people doing it with ease, may be fruits of their hard work Recently i found an article mentioning pathway localisation after atrial pacing during EP study.Amazingly it works well on surfaceContinue reading “Pin pointing the pathway !”

ECG in Ebsteins anomaly

“Most of chd children dont look sick, but the scars on their chest are real .They are battle scars, the scars of their fight to live” anonymous Ecg is almost never normal in ebsteins anomaly of the heart.The range of anomalies include the following,The PQRST way P wave -right atrial enlargement is almost always seenContinue reading “ECG in Ebsteins anomaly”

ECG changes in VSD

Ventricular septal defects can present with a myriad of ECG changes.What matters is the size of vsd and associated anomalies Normal ecg -In a small defect,its not uncommon to find a normal ekg. LVH with left atrial abnormality-common pattern in a left to right shunt especially moderate to large RVH-Suspect raised RV pressures in largeContinue reading “ECG changes in VSD”

An abnormal U wave !

U wave, one of the most forgotten wave in ecg. It’s often submerged beneath pqrst wave analysis even by experts. Let’s have a glance on this small hump.Given below as points….  The most common theories for the origin are: Delayed repolarization of purkinje fibres Prolonged re-polarisation of mid-myocardial M-cells After-potentials resulting from mechanical forces inContinue reading “An abnormal U wave !”

Arm lead reversal vs Dextrocardia in ecg

Reversal of arm leads is the commonest error when recording an ecg/ekg. Negative P in lead 1 is an useful diagnostic clue. Chest leads show normal transition with tall R in lead reversal , whereas in true mirror-image dextrocardia the QRS complex becomes smaller and displays mostly QS or rS in v4-v6. Also as weContinue reading “Arm lead reversal vs Dextrocardia in ecg”

Exercise ECG aka “TMT test”

When not to do? Treadmill and cardiology have an evergreen affair.Treadmill is known to give the user not just an exemplary cardiac fitness ,but diagnose serious heart diseases.But what if treadmill can lead to death!! yes it can sometimes… Exercise ecg testing is quite popular in clinical cardiology for more than 50 years.It can beContinue reading “Exercise ECG aka “TMT test””