ECG of the Week - 16th April 2012 - Interpretation

A cold ECG for interpretation this week with no clinical information.

Click to enlarge

Rate:

• 96

Rhythm:

• Regularly irregular
• Alternating sinus & premature ventricular complex (PVC)

Axis:

• Normal (50 deg)

Intervals:

• PR - Short (~80ms)
• QRS - Sinus complex - normal (80ms)
• QRS - PVC - prolonged (160ms)
• QT - 360ms

Segments:

• Sinus Complexes - ST elevation V3
• PVCs - ST elevation aVR, aVL,V1-3
• PVCs - ST depression II, III, aVF, V4-6

Additional:

• RSR' Pattern V1
• LVH - difficult to see but S V1 + R V5 likely >35mm 
• PVCs - T inversion II, III, aVF, V4-6
• PVCs - dominant R wave laterally

Interpretation:

• Bigeminy
• PVCs - LBBB Morpholgy & Appropriate ST segement & T wave discordance
• Short pr

Causes

• Idiopathic
• Ischaemia
• Electrolyte abnormalities
• Drugs
• Digitalis Toxicity

References / Further Reading

Life in the Fast Lane

• Left Ventricular Hypertrophy here 
• Premature Ventricular Complexes here

eMedicine

• Premature Ventricular Complexes here

Textbook

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