Wednesday, 13 June 2012

ECG of the Week - 11th June 2012 - Interpretation

Another ECG on the same patient as the last 2 weeks.








Click to Enlarge
Rate:
  • 35
Rhythm:
  • Regular
  • Absent p waves

Axis:
  • Normal (+45 deg)
Intervals:
  • PR - p waves absent
  • QRS - Normal (120ms)
  • QT - 360ms (QTc Bazette ~ 270 ms)
Additional:
  • T Inversion aVR, V1

Interpretation:

  • Junctional Bradycardia
  • Junctional Escape 
    • QRS Morphology similar to previous ECGs

Differential

  • Drugs - patient received beta-blockers, unknown as whether on calcium-channel blockers or digoxin
  • Ischaemia
  • Sinus Node Dysfunction - Tachy-Brady Syndrome
  • Electrolyte Abnormalities e.g hyperkalaemia

References / Further Reading




Life in the Fast Lane

  • Junctional Rhythm here
  • Sinus Node Dysfunction here
Textbook
  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.