Wednesday, 4 April 2012

ECG of the Week - 2nd April 2012 - Interpretation

This weeks ECG is from an 82 yr old.




Click to enlarge
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.