ECG of the Week - 20th August 2012 - Interpretation

This ECG is from a 12 day old boy.





Click to enlarge

• ECG taken at 50 mm/s (usual paper speed is 25 mm/s)
• V4-6 not on ECG Paper


Rate:

• ~310
• As 50 mm/s Rate = number of big squares between R-R complex divided into 600 (or)
• As 50 mm/s Rate = number of small squares between R-R complex divided into 3000

Rhythm:

• Regular
• Nil P Waves Visible

Axis:

• RAD (105 deg)

Intervals:

• PR - Nil p waves visible
• QRS - Narrow (40ms)
• QT - 140ms

Additional/Segment:

• Incomplete Precordial Leads Limit Interpretation

Interpretation:

• Narrow Complex Tachycardia / SVT

Causes

• ~50% of Paediatric SVTs have no underlying heart disease
• Can be secondary to fever & drugs
• ~25% of Paediatric SVTs have congential heart disease
• ~25% of Paediatric SVTs have WPW

Read more on Paediatric ECGs -Normal and Abnormal here

Below is an ECG taken on the same patient at standard calibration (25mm/s)

Click to enlarge

References / Further Reading

Life in the Fast Lane

• Paediatric ECG Interpretation here
• SVT here

Textbook

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