Wednesday, 15 August 2012

ECG of the Week - 13th August 2012 - Interpretation

This ECG is from an 18 year old male who presents following a minor injury



Click to enlarge

Rate:
  • Ventricular Rate ~55
  • Atrial Rate ~84
Rhythm:
  • Regular Ventricular Conduction
  • P Waves not associated with QRS Complexes

Axis:
  • Left Axis Deviation (-70 deg)
Intervals:
  • QRS - Normal (100ms)
  • QT - 400ms
Additional:

  • Biphasic T wave V2
  • aVL R Wave >11mm
  • Dominant R Waves V1-4
  • R/S V6 < 1 (Just)
  • QRS Slurred Upstroke Precordial Leads
  • QRS rSr' in inferior leads

Interpretation:

  • 3rd Degree AV Block
  • Features of both LVH & RVH
    • ? Biventricular Enlargement
This patient had a known history of congenitial cardiac disease

References / Further Reading


Life in the Fast Lane

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