Cardiologists in Sahakaranagar Congenital heart disease Again, the ECG patterns are not very distinctive: they are mostly those of chamber hypertrophy, often masked at a later stage by conduction defects Some may be of clinical value: LAD in a young patient may suggest the likelihood of endocardial cushion defects or tricuspid atresia; and a precordial rS morphology may suggest or confirm the suspicion of Noonan’s syndrome. Sinus tachycardia of 164/minute in a stuporous 60-year-old woman with markedly elevated thyroid hormone levels and associated hypercalcaemia. L2 and L3 suggest, superficially, two atrial complexes in each cycle, but the simultaneously recorded L1 above them excludes it. In the accident and emergency department this trace was originally thought to represent atrial flutter with 2:1 block (a double error—if it were atrial flutter, 3:1 block should be present). Myxoedema was diagnosed in this postoperative 65-year-old patient because of the absolute small voltage and impressive loss of T wave amplitude. The sinus rate is, atypically, 92/minute. Her QT interval should be 0.35 seconds but was measured to be 0.39 seconds. The PR interval is only 0.12 seconds and may represent an unrelated LGL-type bypass conduction. A group of genetic disorders are defined by their ECGs—the so-called channelopathies. These include the congenital long QT syndromes (Romano-Ward and Lange-Jervell-Nielsen) and the newly described short QT syndrome, 31 as well as the Brugada syndrome These abnormalities are associated with an increased risk of sudden death, and high-risk patients should be considered for implantation of a cardioverter-defibrillator.