ECG of the Week - 27th February 2012 - Interpretation

This weeks ECG was from a 71yr old female.

Click to enlarge

Rate:

• 72

Rhythm:

• Regular
• Sinus Rhythm

Axis:

• Borderline LAD (-33 deg)

Intervals:

• PR - Normal (~200ms)
• QRS - Normal (100ms)
• QT - 400ms (QTc Bazette ~ 430 ms)

Segments:

• Minor Intraventricular conduction delay

Additional:

• Low voltage
• T inversion V1-3
• U waves V3-5
• Poor R wave progression

                               
Interpretation:

• Low voltage ECG
• Non-specific T wave changes
• Borderline LAD

Low QRS Voltage ECG Definition

• QRS Voltage less than 0.5mV (5mm) in all limb leads
• QRS Voltage less than 1mV (10mm) in all precordial leads

Causes of low voltage ECG include:

• ECG Calibration Error
• Body habitus e.g. obesity
• Pericardial Effusion
• Pleural Effusion
• Fluid Retention e.g. anasarca, cardiac failure, nephrotic syndrome, myxodema
• Infiltrative Cardiomyopathy
• COAD (hyperinflated lungs)
• Pneumothorax

References / Further Reading

Life in the Fast Lane

• Low QRS Voltage here

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.