Wednesday, 11 April 2012

ECG of the Week - 9th April 2012 - Interpretation

This weeks ECG is another ECG taken from last weeks 82yr old female.






Click to enlarge

Rate:
  • 83
Rhythm:
  • Paced
  • Regular
Axis:
  • LAD (-73 deg)
Intervals:
  • PR - Ventricular Paced Rhythm
  • QRS - Prolonged (160ms)
  • QT - 720ms (QTc Bazette ~ 820 ms)
Segments:
  • ST Elevation II, III, aVF, V4-5
  • ST Depression I, aVL, V2, V6

Additional:
  • T Inversion I, aVL, aVR, V2
  • P waves V2,3 following QRS
  • Prominent R wave I, aVL, aVR, V6

Interpretation:
  • Paced Rhythm
  • LBBB Morpholgy & LAD
  • ST Segment & T wave Changes - Appropriate discordance in keeping with paced rhythm
  • ? Retrograde p waves ? Native activity
  • QT Prolongation - ? can you comment on in paced rhythm ?

  
References / Further Reading

Life in the Fast Lane

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