Wednesday, 22 August 2012

ECG of the Week - 20th August 2012 - Interpretation

This ECG is from a 12 day old boy.









Click to enlarge
  • ECG taken at 50 mm/s (usual paper speed is 25 mm/s)
  • V4-6 not on ECG Paper

Rate:
  • ~310
  • As 50 mm/s Rate = number of big squares between R-R complex divided into 600 (or)
  • As 50 mm/s Rate = number of small squares between R-R complex divided into 3000
Rhythm:
  • Regular
  • Nil P Waves Visible
Axis:
  • RAD (105 deg)
Intervals:
  • PR - Nil p waves visible
  • QRS - Narrow (40ms)
  • QT - 140ms
Additional/Segment:
  • Incomplete Precordial Leads Limit Interpretation
Interpretation:
  • Narrow Complex Tachycardia / SVT
Causes

  • ~50% of Paediatric SVTs have no underlying heart disease
  • Can be secondary to fever & drugs
  • ~25% of Paediatric SVTs have congential heart disease
  • ~25% of Paediatric SVTs have WPW
Read more on Paediatric ECGs -Normal and Abnormal here



Below is an ECG taken on the same patient at standard calibration (25mm/s)

Click to enlarge
References / Further Reading


Life in the Fast Lane

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