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- 75 bpm
- Sinus rhythm
- PR - Short (100 ms)
- QRS - Prolonged (120 ms)
- QT - 380 ms (QTc Bazette 425 ms)
- ST Elevation leads aVR, V1-3
- ST Depression leads I, II, III, aVF, V5-6
- Delta Waves leads I, II, III, aVF, V5-6
- Voltage criteria for LVH
- S wave V1 + R wave V5 > 35mm
- NOTE in the setting of pre-excitation this reflects the pre-excitated depolarisation rather than morphological LVH
- Wolff-Parkinson-White (WPW)
- PR Shortening
- QRS Prolongation
- Delta Waves
- Anteroseptal pathway (Arruda Algorithm)
- ST changes and apparent / 'pseudo' LVH due to pre-excitation
The patient had a normal chest x-ray and a diagnosis of chest wall pain was made. There was no prior history of syncope or palpitations and she was referred for paediatric cardiology follow-up.
References / Further Reading
- Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.