Electrical Alternans

Electrical Alternans is an electrocardiographic manifestation in which there is alternation in the amplitude of the QRS complex, the T wave alone, OR Both QRS and T wave. It often accompanies fast rates and then has no prognostic significance. When found with slow rates, it connotes organic heart disease with an adverse prognosis. Electrical Alternans may occasionally be associated with a pericardial effusion and is usually seen in midprecordial leads. Electrical Alternans does not cause a disturbance of rhythm.

Hypothermia and Therapeutically Induced Mild Hypothermia

Hypothermia ECG manifestations of Hypothermia are:- Development of J wave :- J wave or Junctional wave or Osborne wave is a hump-like deflection which occurs at the junction of the distal limb of the QRS complex with the ST segment. The amplitude of this deflection is proportional to the degree of hypothermia. It is consistently present when the body temperature is below 25 degree celsius. J wave is most prominent in leads oriented to the left ventricle. PR segment depression QRS prolongation ST segment depression T wave inversion QT interval prolongation Muscle tremors, which are reflected as shivering artefacts Cardiac … Read more

ECG in various Drug and Electrolyte Effects

Digitalis Effect ECG in digitalis is manifested as:- Straight downwards slope with a sharp terminal rise like mirror image of a check or correction mark. This does not coonote toxicity and is seen in digitalis therapeutic doses. However, if the beginning of ST segment with the inverse check mark configuration is already depressed below the isoelectric level, it may then be an expression of digitalis toxicity. T wave amplitude is diminished in therapeutic doses of digitalis however, T wave becomes inverted when digitalis toxicity sets in. QT interval shortens as digitalis accelerates the recovery of the ventricular subendocardium. Paroxysmal atrial … Read more

ECG in Mitral Valve Prolapse (MVP)

MVP refers to a systolic billowing of one or both mitral leaflets into left atrium with or without mitral regurgitation. The prevalence of this entity is 1% to 2.5% in the population The disease can be primary or secondary in occurence. The primarry MVP syndrome is autosomal inherited while the secondary causes may be due to conditions like Coronary Artery Disease (CAD) , Acute rheumatic carditis , Hypertrophic cardiomyopathy , WPW syndrome etc. ECG features of Primary MVP syndrome:– Mostly the ECG is normal and diagnosis is dependent on clinical auscultation and Echocardiographic findings. However, some abnormalities seen in patients … Read more

ECG in Systemic Hypertension

Systemic Hypertension may manifest electrocardiographically in the following manner:- Electrocardiographic signs of left venticular hypertrophy due to systolic overload Electrocardiographic signs of left atrial abnormality Left Axis Deviation because of chronic systemic hypertension ECG features of Left Ventricular Hypertrophy There are deep S waves in the right oriented leads Tall R waves in the left oriented lead The sum of S wave in leads V1 and R wave in lead V6 is 50mm ECG features of Left Ventricular systolic overload There is a wide frontal plane QRS-T angle T wave is inverted in Left oriented leads