Wednesday, 17 October 2018

ECG of the Week - 15th October 2018 - Interpretation

This ECG is from a 45 yr old female who presented after an episode of chest pain. She has no past medical history and takes no regular medications. She has a positive family history of cardiac disease.



Click to enlarge

Rate:
  • 60 bpm
Rhythm:
  • Sinus arrhythmia
Axis:
  • Extreme axis deviation
Intervals:
  • PR - Normal 
  • QRS - Normal (100ms)
Additional:
  • Partial RBBB
  • U waves inferior leads
  • T wave inversion leads I & aVF 
    • Note P and QRS inversion
  • Flat T waves leads V2 & V3
Interpretation:

  • Lead reversal LA / RA
  • Results in:
    • Inversion lead I
    • Swap aVL & aVR
    • Swap lead II & III


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.

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