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Stepwise interpretation of ECG - #06 no Dx ID168

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  • 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. (1 st 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