Wednesday, 13 March 2013

ECG of the Week - 11th March 2013 - Interpretation

This week's ECG is from a 57 year old female.
I don't have any presenting complaints for this case but it is likely she would complain of weakness.
Click to enlarge
  • 60 bpm
  • Sinus Arrhythmia
  • Normal (50 deg)
  • PR - Prolonged (~220ms)
  • QRS - Normal (100ms in lead II, prolonged in lead V2)
  • Apparent QT - 680ms (QTc Bazette ~ 710 ms)
  • ST Depression Leads I, II, V2-6
  • ST Elevation aVR
  • Ventricular Ectopic
  • Prominent U waves
  • T-U Fusion
    • Best visualised in leads II, III, aVF, V2-6
    • Initial T wave is inverted and merges with large U wave
    • Results in apparent QT prolongation due to fusion
    • Best considered QU prolongation
  • Multiple ECG features consistent with hypokalaemia +/- hypomagnesaemia
This patient had a K+ of 1.6 mmol/L confirmed by a VBG, result below.
References / Further Reading
Life in the Fast Lane
  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.