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

• Rate

Textbook

• Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.