Wednesday, 21 November 2018

ECG of the Week - 19th November 2018 - Interpretation

The following pre-hospital ECG is from a 30 yr male sent in from dysponea and chest tightness, with concern regarding bradycardia.


Click to enlarge

Calibration:

  • The give away to this ECG is the very bottom of the paper.
  • This has been done with non-standard calibration of 50 mm/s.
  • This is why:
    • The ECG spans several pages
    • Why there are only 6 leads represented here
    • Why the rate at first glance appears to be very slow.
    • Why everything looks prolonged, at 50mm/s each big square now represents 100ms with each small square 20ms.

Rate:
  • 65 bpm
Rhythm:
  • Regular
  • Sinus rhythm
Axis:
  • Normal (-33 deg)
Intervals:
  • PR - Normal (~140ms)
  • QRS - Normal (80ms)
Additional:
  • Incomplete ECG only 6 leads represented on the A4 sheet
  • Secondary to adjusted paper speed
  • This ECG was 3 A4 Pages long ! 

Interpretation:

The ECG was repeated with standard calibration and was normal !

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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