ECG of the Week - 9th July 2012 - Interpretation

This weeks ECG was from a 25 year old female.

Click to enlarge

Rate:

• ~125

Rhythm:

• Sinus Arrhythmia

Axis:

• Right Axis Deviation (~120 deg)

Intervals:

• PR - Normal (~120ms)
• QRS - Normal (80ms)
• QT - 300ms (QTc Bazette ~ 390 ms)

Segments:

• Slight ST Depression Leads II, III, aVF

Additional:

• P wave Inversion Leads I, aVL

Interpretation:

• Sinus Tachycardia

• RA / LA Lead Reversal
• Leads aVR / aVL swap places
• Lead I becomes inverted
• Leads II / III swap places
• Resultant RAD, p inversion I & aVL

This patient had the right arm and left arm electrodes reversed and hyperthyroidism causing her tachycardia

References / Further Reading

Life in the Fast Lane

• Limb Lead Reversals here
• Right Axis Deviation here
• ECG in hyperthyroidism here

Textbook

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