[expand title=”Interpretation”]
Rate:
Atrial = 82 min-1
Ventricular = 82 min-1
Rhythm:
Sinus rhythm
P waves:
Duration = 80 ms
Amplitude = 0.15 mV
PR interval:
Duration = 60 ms
Morphology = normal
QRS complex:
Duration = 130 ms
Axis = -4°
Q Waves:
III, aVF
R wave progression:
Normal
LV Hypertrophy [Sokolow; SV1 + (RV5 or RV6) > 35mm) or RI + SIII > 25mm]?
Yes
RV Hypertrophy [R/S ratio V5 or V6 < 1 or R/S ratio V1 > 1 or S1S2S3 pattern]?
No
ST segments:
Duration = 120 ms
Morphology = sagging downslope V1, V2
T waves:
Duration = 120 ms
Morphology = inverted aVL, V1, V2, biphasic I
QT interval:
QT duration = 380 ms
QTc duration = 443 ms
Additional comments:
Prominent delta wave.
Interpretation: This is Wolff-Parkinson-White Syndrome type B (prominent S wave in V1, as opposed to the tall R wave observed in type A). The very tall QRS complexes are part of the disease and do NOT represent left ventricular hypertrophy (although these are very tall in this case). This patient was known to have WPW and presented with abdominal pain. This was a routine ECG and the patient was normotensive.
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