[expand title=”Interpretation”]
Rate:
Atrial = 62 min-1
Ventricular = 62 min-1
Rhythm:
Sinus rhythm with a run of bigeminy
P waves:
Duration = 90 ms
Amplitude = 0.1 mV
PR interval:
Duration = 140 ms
Morphology = normal
QRS complex:
Duration = 90 ms
Axis = 90°
Q Waves:
Nil
R wave progression:
Normal
LV Hypertrophy [Sokolow; SV1 + (RV5 or RV6) > 35mm) or RI + SIII > 25mm]?
No
RV Hypertrophy [R/S ratio V5 or V6 < 1 or R/S ratio V1 > 1 or S1S2S3 pattern]?
No
ST segments:
Duration = 100 ms
Morphology = normal
T waves:
Duration = 200 ms
Morphology = normal
QT interval:
QT duration = 410 ms
QTc duration = 430 ms
Additional comments:
Bigeminal ectopics complexes (6, 8 and 10 on rhythm strip). Prominent U waves.
Interpretation: Sinus rhythm with bigeminy suggests electrolyte disturbance or drug effects. The obvious U wave is seen in some young people, hypokalaemia, athletic hearts, CNS disorders and drugs such as sympathomimetics, digoxin, quinidine and amiodarone. History is important. This patient was 25-years-old with a history of anorexia/bulimia. No drugs involved. Electrolytes: Potassium was 1.9.
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