[expand title=”Interpretation”]
Rate:
Atrial = 71 min-1
Ventricular = 71 min-1
Rhythm:
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:
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 = 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:
Nil
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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