ECG of the Week - 8th May 2017 - Interpretation

The following ECG is from a 12 yr old who presented to the Emergency Department following an episode of dysponea and palpitations.

 

Click to enlarge

Rate:

 

• 72 bpm

Rhythm:

 

• Sinus rhythm
• Note baseline irregularity due to printing issue

Axis:

• Normal

Intervals:

 

Complexes #1-9, #12

• PR - Normal
• QRS - Normal

Complexes #10-11

• PR - Short
• QRS - Prolonged

Additional:

• Distinct QRS morphology complexes #10-11
• Delta wave
• Abnormal ST / T wave likely secondary to pre-excitation

Interpretation:

• Intermittent pre-excitation / WPW
• Only seen in complexes #10-11

What happened ?
 

The patient was referred to paediatric cardiologists for further follow-up and investigation.

 

References / Further Reading

 

Life in the Fast Lane

• Pre-excitation

Textbook

 

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