ECG of the Week - 9th April 2018 - Interpretation

The following ECG is from an 18 month old female following a potential accidental medication ingestion.



Click to enlarge

Rate:

• 108 bpm

Rhythm:

• Regular
• Sinus rhythm 

Axis:

• Inferior (+90 deg)

Intervals:

• PR - Normal (~130ms)
• QRS - Normal (100ms)
• QT - 320 ms

Additional:

• Dominant R wave V1-3
• T wave inversion leads V1-4
• Inferior Q wave - maximal in lead III

Interpretation:

• Age appropriate ECG 
• No concerning toxicological features
• Normal paediatric features including:
• Heart Rate
• T-wave changes
• Right precordial QRS voltages & T wave changes

Variations in Paediatric ECG features

The paediatric ECG has a range of normal variants that are different from the adult ECG and are also dependent on the child's age.
For a great overview of paediatric ECG variants and normal ranges check out:

• LitFL - Paediatric ECG Interpretation

References / Further Reading

 

Life in the Fast Lane

 

• Paediatric ECG

Textbook

 

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