Tag Archives: electrocardiogram (ECG)

We recorded an ECG (figure 1) in a 50-year-old Caucasian woman when she attended our clinic for atypical chest pain and a history of familial hypercholesterolaemia. Her medication included atorvastatin and ferrous sulphate only. Cardiovascular examination was unremarkable. The ECG shows a very large U-wave, but was otherwise normal. Because of the disproportionally large U-wave, she underwent extensive investigations. Her echocardiogram, exercise stress echocardiogram and 24-hour Holter monitor were all normal. Her blood tests showed normal thyroid function, normal serum potassium (4.4 mmol/L) and calcium (2.4 mmol/L). Figure 1. A 12-lead ele

Introduction The significance of the frontal QRS-T angle (QTA), the difference between the QRS-axis and T-axis, has not been widely recognised in clinical practice, though it is widely available on 12-lead ECGs recorded by a modern electrocardiograph.1,2 An abnormally wide QTA represents an abnormality of ventricular depolarisation or repolarisation, and is known to be an independent predictor of cardiovascular mortality secondary to ischaemic events, sudden death, death from arrhythmia, increased incidence of congestive heart failure, as well as all-cause mortality.2-5 It has even been considered as a stronger predictor of poor prognosis tha

Introduction Due to the asymmetry of the heart, it has long been described in what is known as the ‘Valentine’ position, in which the heart is oriented vertically downwards. It defines the heart as a solitary organ and provides no reference point for its location within the chest. This description has since been found to be inaccurate, as we know the heart is positioned in a direction extending from the right shoulder to the left hypochondrium. The in vivo orientation of the heart takes into account its surrounding bony structures and is the best definition of true anatomical heart position.1,2 Figure 1. Pathway of cardiac electrical acti