ECG of the Week - 21st July 2014 - Interpretation

This ECG is from a 50 yr old male who presented complaining of productive cough and fever for 2 days.
Check out the comments on this case in our original post here.

Click to enlarge

Rate:

• 67 bpm

Rhythm:

• Regular
• Sinus Rhythm

Axis:

• Normal

Intervals:

• PR - Short (~100ms)
• QRS - Prolonged (140-160ms)
• QT - 400ms (QTc Bazette 410 ms)

Segments:

• ST elevation leads aVR, V1-3
• ST depression leads I, II, III, V4-6

Additional:

• Delta wave 
• Best seen leads I, II, III, aVF, V4-6
• T wave inversion lead aVL
• Broad P wave lead II with notching of peak

Interpretation:

• Wolff-Parkinson-White
• Anteroseptal pathway

For the variety of ways WPW can influence the ECG please check out this excellent post from Dr Steve Smith here:

• A Certain Pattern of Pseudo-STEMI with and without superimposed STEMI

References / Further Reading

Life in the Fast Lane

• Pre-excitation Syndromes

Textbook

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