ECG #7

ECG #7

[expand title=”Interpretation”]



Atrial = 62 min-1

Ventricular = 62 min-1


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:


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 = 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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