Nelson’s ECG review January 2015

  1. Junctional premature beat can simulate a first degree AV block by concealed retrograde conduction into AV node.
    – Consider a “hidden” JPB if there is sudden unexplained prolongation of PR interval.
    Picture1
  2. Hypokalemia can cause weakness by hypokalemic periodic paralysis. Do an ECG for patient with unexplained weakness !
  3. Pericardial tamponade: look for low QRS voltage (sum of R wave in limb leads < 5mm, in precordial leads <10mm) + tachycardia, electrical alternans can help but not always present
  4. Bix rule:  if a P-wave is located halfway between two QRS complexes, there’s a good chance there is also a P-wave buried inside the QRS as well. It is normally an atrial flutter with 2:1 conduction
    Picture1
    P waves in the middle of two QRS complexes
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