ECG of the Week - 5th March 2012 - Interpretation

This weeks ECG was from a 97 yr old brought into the Emergency Department having been found collapsed at home.

Click to enlarge

Rate:

• 30

Rhythm:

• Irregular
• No p waves visible

Axis:

• Normal (+20 deg)

Intervals:

• PR - no p waves visible
• QRS - prolonged (160ms)
• QT - 720-760ms (QTc Bazette 570-600 ms)

Segments:

• Inferior ST sagging

Additional:

• Right bundle branch block
• Terminal QRS Notching - J wave

Interpretation:

• Bradycardia
• Slow atrial fibrillation
• J waves
• QT Prolongation

• ECG Findings consitent with hypothermia
• Patient's core temperature was 28C (82F)

References / Further Reading

Life in the Fast Lane

• Hypothermia here

ECGpedia

• Hypothermia here

eMedicine

• Hypothermia here

Textbook

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