Wednesday, 11 April 2018

ECG of the Week - 9th April 2018 - Interpretation

The following ECG is from an 18 month old female following a potential accidental medication ingestion.


Click to enlarge

Rate:
  • 108 bpm
Rhythm:
  • Regular
  • Sinus rhythm 
Axis:
  • Inferior (+90 deg)
Intervals:
  • PR - Normal (~130ms)
  • QRS - Normal (100ms)
  • QT - 320 ms
Additional:
  • Dominant R wave V1-3
  • T wave inversion leads V1-4
  • Inferior Q wave - maximal in lead III
Interpretation:
  • Age appropriate ECG 
  • No concerning toxicological features
  • Normal paediatric features including:
    • Heart Rate
    • T-wave changes
    • Right precordial QRS voltages & T wave changes

Variations in Paediatric ECG features

The paediatric ECG has a range of normal variants that are different from the adult ECG and are also dependent on the child's age.
For a great overview of paediatric ECG variants and normal ranges check out:

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