stepwise interpretation ECG #6
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This document summarizes the stepwise interpretation of an ECG for a 78 year old woman with a heart murmur. It was found that she had sinus rhythm at 77 beats per minute with sinus arrhythmia. She also had first degree AV block seen by a prolonged PR interval of 230 ms. Examination of the QRS complexes and axes found normal duration and no signs of bundle branch blocks. There were findings of left ventricular hypertrophy seen with ST-T abnormalities indicating strain pattern. No signs of myocardial infarction were seen.
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stepwise interpretation ECG #6
- 1. Stepwise interpretation of ECG ID 168
- 2. ID 168 78 year old woman with a heart murmur
- 3. ID 168 78 year old woman with a heart murmur Can you see P waves?
- 4. ID 168 – Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block Yes, there is sinus rhythm, 77/min. The P-P interval varies in keeping with sinus arrhythmia (a common normal finding) – Each P is followed by a QRS – The P-R is prolonged to 230 msec. (1st degree AV block)
- 5. ID 168 - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block There are no signs of right or left atrial enlargement
- 6. ID 168 - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block Let’s now look at the QRS complexes: There is normal QRS axis (between 0 and 90 degrees
- 7. The QRS duration is normal : There is no right bundle branch block, left bundle branch block or non‐specific block ID 168 - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block
- 8. ID 168 - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block – Left ventricular hypertrophy with repolarization abnormality There are findings of left ventricular hypertrophy with ST-T abnormality (“strain pattern”)
- 9. ID 168 Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block Left ventricular hypertrophy with repolarization abnormality There are no QRS changes of myocardial infarction
- 10. ID 168 Final diagnosis - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block Left ventricular hypertrophy with repolarization abnormality