Wednesday, 16 December 2015

ECG of the Week - 14th December 2015 - Interpretation

The following ECG is from a 50 yr old female who presented with multiple complaints including dysponea, joint pain, abdominal pain and chest pain.
Check out the comments from our original post here.





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Labelled Version
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Rate:
  • Mean ventricular rate 60 bpm
  • Regular atrial activity rate 60 bpm
    • Atrial activity marked by red lines
Rhythm:
  • Irregular
  • Complexes #1-3 sinus
  • Complex #4 Premature junctional complex
    • Narrow complex with no obvious preceding P wave
    • Note non-conducted p wave within T wave
    • Followed by compensatory pause
  • Complex #5 Premature junctional complex
    • Preceding P wave has very short pr (~70 msec)
  • Complexes #6-7 sinus
  • Complex #8 as per complex #4
  • Complex #9 as per complex #5
  • Complex #10 sinus
Axis:
  • Sinus complexes: Normal axis
Intervals:
  • Sinus complexes (#1-3, 6-7 & 10)
    • PR - Normal (~160ms)
    • QRS - Normal (80ms)
  • Premature junctional complexes (#4,5,8,9)
    • PR - Absent P wave (#4,8) or very short (#5,9)
    • QRS - Normal (80-100ms)
Segments:
  • Nil significant changes
Additional:
  • Complex #8 has partial RBBB morphology
Interpretation:
  • Sinus rhythm
  • Frequent premature junctional complexes
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.