Wednesday, 26 September 2012

ECG of the Week - 24th September 2012 - Interpretation

This ECG is from a 55 year old with chest pain.






Click to enlarge



Rate:
  • Atrial rate ~115-120
  • Ventricular rate ~ 48
Rhythm:
  • Regular ventricular complexes
  • No relationship between atrial & ventricular activity

Axis:
  • Normal (+45 deg)
Intervals:
  • PR - No relationship between P waves & QRS complexes
  • QRS - Normal (80ms)
  • QT - 360ms (QTc Bazette ~ 320 ms)
Segments:

  • ST Elevation - II (2mm), III (3mm), aVF (2mm), V6 (1mm)
  • ST Depression I, aVL, V2-4

Interpretation:

  • Bradycardia
  • Inferior STEMI
  • ? Posterior Extension - flat ST Depression V2-3
  • Complete Heart Block with Junctional Escape Rhythm

Check out Christopher's comments on this ECG, he beat us to it on the interpretation side, and I promise we didn't just cut & paste his thoughts. You can check out Christopher's blog here for some more interesting ECG's and discussions.


References / Further Reading

Life in the Fast Lane

  • Inferior STEMI here
  • Complete Heart Block here
  • Junctional Escape Rhythm here
Textbook
  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.