Some ECG finding in heart diseases - 2

Pulmonic stenosis:
1-P congenitale
2-right ventricular systolic overload
3-right axis deviation

Tricuspid atresia:
1-left axis deviation
2-left ventricular dominance
NB: MOST cases of cyanotic congenital heart disease are associated with RIGHT ventricular dominance and RIGHT axis deviation ; tricuspid atresia is a notable exception .

Ebstein's anomaly:
1-TALL peaked P waves in standard lead II
2-RBBB with small amplitude QRS complexes
3-WPW syndrome type B, ie the QRS complex is negative in the right precordial leads 4-paroxysmal supra-ventricular tachycardia

Mirror image dextro-cardia:
1-Inverted P waves in standard lead I
2-all other deflections –QRS complex and T wave- are also negative in standard lead I.
3-This lead now resembles a normal lead aVR.
4-the normal appearances of standard leads II and lead III are interchanged .
5-the QRS complexes are tallest in the right precordial leads –V1 and V2- and diminished progressively towards the left.

Limb lead reversal:
This will manifest as a mirror image dextro-cardia but the precordial lead complexes are NORMAL.

Anomalous left coronary artery:
When the left coronary artery arises from the pulmonary artery ,the ECG reflects the pattern of ANTERO-LATERAL myocardial infarction, viz pathological q waves, raised coved ST segments and inverted T waves in standard lead I and aVL and the left precordial leads.

Causes of SA block: SA block is a rare ECG finding and might be caused by:

1-marked sinus bradycardia
2-marked sinus arrhythmia
3-highly trained young athletes
4-digitalis toxixity
5-uremia
6-hypokalemia
7-sick sinus syndrome

1st degree AV block is associated with:
1-coronary artery disease
2-acute rheumatic carditis
3-Beta blockers
4-digitalis
5-cardiomyopathy

NB: Para systoles; parasystole is an uncommon arrhythmia .It may occur with myocardial diseases and following digitalis administration, however it might be seen in normal healthy people. There is no specific treatment and the treatment is of the underlying disease if present.

Category: Cardiology Notes