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eFigure 10–14. Right atrial enlargement (RAE) and right ventricular hypertrophy (RVH). RAE is recognized by the tall (> 2.5 mm) P waves in leads II, III, and aVF. RVH is likely because of right axis deviation (+100 degrees) and the Qr (or rSR') complexes in V1–2. Reproduced with permission from Frank Yanowitz. Right atrial enlargement (RAE) ECG Learning Center. https://ecg.utah.edu/img_index. A 12 lead electrocardiograph shows the rhythmic tracing indicative of right atrial enlargement and right ventricular hypertrophy.

Current Medical Diagnosis & Treatment 2023 > Pulmonary Valve Stenosis

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eFigure 10–41. ST-segment elevation myocardial infarction (STEMI). Normal sinus rhythm to 60 beats per minute with ST elevations across the precordium (V1–V5) with reciprocal ST depressions inferiorly (II, III, aVF) concerning for proximal left anterior descending (LAD) lesion causing ischemia. Note the hyperacute T waves along the precordium, which are also a sign of acute ischemia. (Reproduced with permission from Jose Sanchez, MD.) A 12 lead electrocardiograph shows the rhythmic tracings as observed in a case of S T E M I.

Current Medical Diagnosis & Treatment 2023 > Acute Myocardial Infarction with ST-Segment Elevation

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eFigure 10–52. Anterior wall aneurysm. The patient had a MI several months before this ECG was taken. Notice the prominent Q waves in leads V1 to V3 and aVL, the persistent ST elevations in these leads, and the reciprocal ST-segment depressions in the inferior leads (II, III, and aVF). The persistence of ST elevations more than 2–3 weeks after an infarction suggests the presence of a ventricular aneurysm. (Reproduced with permission from Goldberger AL et al. Clinical Electrocardiography: A Simplified Approach, 9th ed. Elsevier; 2018.) An electrocardiograph tracing shows the patterns indicative of an anterior wall aneurysm.

Current Medical Diagnosis & Treatment 2023 > Acute Myocardial Infarction with ST-Segment Elevation

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eFigure 10–56. Left anterior fascicular block. Note the qR complexes in leads I and aVL and rS complexes in II, III, and aVF. Also note the prolonged R-wave peak time in aVL (the time from onset of the QRS to the peak of the R wave > 45 msec). (Reproduced with permission from Alemzadeh-Ansari MJ. Electrocardiography. In: Maleki M Et al. (ed), Practical Cardiology. Elsevier, 2018.) An electrocardiograph tracing shows the pattern indicative of left anterior fascicular block.

Current Medical Diagnosis & Treatment 2023 > Atrioventicular Block

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eFigure 10–57. Left posterior fascicular block. Note the rS complexes in leads I and aVL and qR complexes in II, III, and aVF. Also note the prolonged R-wave peak time in aVF (the time from onset of the QRS to the peak of the R wave > 45 msec). (Reproduced with permission from Alemzadeh-Ansari MJ. Electrocardiography. In: Maleki M Et al. (ed), Practical Cardiology. Elsevier, 2018.) An electrocardiograph tracing shows the pattern indicative of left posterior fascicular block.

Current Medical Diagnosis & Treatment 2023 > Atrioventicular Block

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eFigure 10–62. Atrial flutter. A: Regular, narrow-complex tachycardia at a ventricular rate of 155 beats/min. B: Atrial flutter with flutter waves most visible in leads 2, 3, and aVF. C: Atrial flutter response to carotid sinus massage inducing transient AV block and unmasking flutter waves. (Reproduced, with permission, from Tintinalli JE, Ma OJ, Yealy DM, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9th ed. McGraw-Hill, 2020.) Three electrocardiograph tracings show the patterns observed in atrial flutter.

Current Medical Diagnosis & Treatment 2023 > Atrial Flutter

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eFigure 10–65. Multifocal atrial tachycardia with varying P-wave morphologies and P-P intervals; right atrial overload with peaked P waves in II, III, and aVF (with vertical P-wave axis); superior QRS axis; slow R-wave progression with delayed transition in precordial leads in patient with severe chronic obstructive lung disease. (Reproduced, with permission from Jameson JL, et al. Harrison’s Principles of Internal Medicine, 20th ed. McGraw-Hill, 2018.) A 12 lead electrocardiograph shows the rhythmic tracing indicative of multifocal atrial tachycardia.

Current Medical Diagnosis & Treatment 2023 > Atrial Tachycardia

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eFigure 10–72. High-output heart failure secondary to arteriovenous fistula. PA chest film at the time of presentation demonstrating cardiomegaly, peri-bronchial cuffing, bilateral pleural effusions, and Kerley B lines. (Reproduced, with permission, from Stern AB, Klemmer PJ. High-output heart failure secondary to arteriovenous fistula. Hemodial Int. 2011;15:104.) A chest x ray reveals enlargement of the heart, pleural effusions, and Kerley B lines.

Current Medical Diagnosis & Treatment 2023 > Heart Failure

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