ECG of the Week - 2nd April 2012 - Interpretation

This weeks ECG is from an 82 yr old.





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Rate:

• 54

Rhythm:

• Sinus rhythm
• Regular

Axis:

• Normal (55 deg)

Intervals:

• PR - Prolonged (~220-240ms)
• QRS - Normal (100ms)
• QT - 560-600ms (QTc Bazette ~ 610 ms)

Segments:

• ST Depression V4-5, II, III, aVF

Additional:

• T Inversion V3-5, II, III, aVF
• ? U Wave ? Biphasic T V4-5, II, aVF

Interpretation:

• 1st Degree AV Block
• Prolonged QT
• ST Segement & T wave Changes

Differentials

• Hypokalaemia
• Other electrolyte abnormailities - hypomagnesaemia, hypocalcaemia
• Ischaemic - acute or chronic
• Drug Effects
• Hypothermia
• Multifactorial - combination of any / all above

References / Further Reading

Life in the Fast Lane

•  1st Degree AV Block here
• QT Interval here

Textbook

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