Describe and interpret this ECG.

ECG #15


Interpretation

 

Rate:

Atrial = 79 min-1

Ventricular = 79 min-1

Rhythm:

First degree atrioventricular block

P waves:  

Duration = 80 ms

Amplitude = 0.1 mV

PR interval:

Duration =  204 ms

Morphology = normal

QRS complex:

Duration = 106 ms

Axis = 45°

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 = elevation I, aVL, V1-5; depression III, aVF

T waves:

Duration = 160 ms

Morphology = hyperacute I, aVL, V2-5; inverted II, aVF

QT interval:

QT duration = 416 ms

QTc duration = 479

Additional comments:

Nil


Interpretation: There is borderline ST elevation with hyperacute T waves in the anterolateral leads (I, aVL, V2-5) and reciprocal ST depression and T wave inversion inferiorly (III, aVF). This is consistent with an acute occlusion of a dominant LAD artery. This patient presented with chest pain, onset 20 minutes prior. The patient should be sent for emergent percutaneous coronary intervention.

ECG #15
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