Friday, 14 September 2012

ECG of the Week - 17th September 2012

I've got no information on this weeks ECG but let's see what we can make of it.

Click to enlarge


  1. Rhythm:
    - Atrial: sinus @ ~90, P-pulmonale (bordering on Himalayan P-waves) consistent with right atrial enlargement
    - Ventricular: 1:1 association with atrial rhythm, 1st degree AVB, narrow complex, albeit focal widening present in some leads, rsR' in V1 consistent w/ incomplete RBBB

    QTc: normal

    ST/T-waves: Concave-upwards ST-elevation appears present in multiple leads (I/II,V2-V6), although relative to the larger Tp-waves present it may not be more than 0.5mm relative to the TP segment. No ST-depression is noted.

    I'm not concerned for STEMI given the large Tp-waves, intact anterior RWP, and absence of reciprocal changes. Appears more consistent with a pulmonary disease pattern.

    Neat tracing!

  2. Hey,
    Could be pulm as suggested above but fits MFAT criteria as well.
    Also bifascicular block if we're being technical.

  3. Hi guys,

    Thanks very much for the comments on this very interesting ECG. The interpretation post should go up in a few hours, although I'm not sure if Cam & I have the answers for this one though.
    Hope you are enjoying the blog and please continue to comment :-)


  4. Thanks Christopher and Rahul, your comments are much appreciated. John and I had fun interpreting this one.
    ....don't worry there's plenty more to get the grey matter going.