Wednesday, 23 July 2014

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:



References / Further Reading

Life in the Fast Lane

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