ECG of the Week - 13th August 2012 - Interpretation

This ECG is from an 18 year old male who presents following a minor injury

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Rate:

• Ventricular Rate ~55
• Atrial Rate ~84

Rhythm:

• Regular Ventricular Conduction
• P Waves not associated with QRS Complexes

Axis:

• Left Axis Deviation (-70 deg)

Intervals:

• QRS - Normal (100ms)
• QT - 400ms

Additional:

• Biphasic T wave V2
• aVL R Wave >11mm
• Dominant R Waves V1-4
• R/S V6 < 1 (Just)
• QRS Slurred Upstroke Precordial Leads
• QRS rSr' in inferior leads

Interpretation:

• 3rd Degree AV Block
• Features of both LVH & RVH
• ? Biventricular Enlargement

This patient had a known history of congenitial cardiac disease

References / Further Reading

Life in the Fast Lane

• Biventricular Hypertrophy here

Textbook

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