ECG #4

ECG #4

ECG #4a


[expand title=”Interpretation”]



Atrial = 71 min-1

Ventricular = 71 min-1


Sinus rhythm

P waves:  

Duration = 80 ms

Amplitude = 0.05 mV

PR interval:

Duration = 190 ms

Morphology = normal

QRS complex:

Duration = 150 ms

Axis = 50°

Q Waves:


R wave progression:


LV Hypertrophy [Sokolow; SV1 + (RV5 or RV6) > 35mm) or RI + SIII > 25mm]?


RV Hypertrophy [R/S ratio V5 or V6 < 1 or R/S ratio V1 > 1 or S1S2S3 pattern]?


ST segments:

Duration = 120 ms

Morphology = normal

T waves:

Duration = 120 ms

Morphology = tall and peaked

QT interval:

QT duration = 444 ms

QTc duration = 493 ms

Additional comments:


Interpretation: These ECGs are from the same patient, 20 mins apart. The patient was a 44 year old male with cirrhosis and renal failure who presented “off his legs”. The initial K+ was 9.6, and the initial ECG shows almost a sinusoidal pattern with very broad QRS and very peaked T waves (the T waves are the taller and broader of the two). There is no discernible P wave activity, although the RR interval is regular. The second ECG is after treatment with calcium and bicarbonate. There is a broad QRS and very peaked T waves. Atrial activity is now obvious.



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