ECG of the Week - 24th September 2012 - Interpretation

This ECG is from a 55 year old with chest pain.







Click to enlarge

Rate:

• Atrial rate ~115-120
• Ventricular rate ~ 48

Rhythm:

• Regular ventricular complexes
• No relationship between atrial & ventricular activity

Axis:

• Normal (+45 deg)

Intervals:

• PR - No relationship between P waves & QRS complexes
• QRS - Normal (80ms)
• QT - 360ms (QTc Bazette ~ 320 ms)

Segments:

• ST Elevation - II (2mm), III (3mm), aVF (2mm), V6 (1mm)
• ST Depression I, aVL, V2-4

Interpretation:

• Bradycardia
• Inferior STEMI
• ? Posterior Extension - flat ST Depression V2-3
• Complete Heart Block with Junctional Escape Rhythm

Check out Christopher's comments on this ECG, he beat us to it on the interpretation side, and I promise we didn't just cut & paste his thoughts. You can check out Christopher's blog here for some more interesting ECG's and discussions.


References / Further Reading

Life in the Fast Lane

• Inferior STEMI here
• Complete Heart Block here
• Junctional Escape Rhythm here

Textbook

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