Stepwise interpretation of ECG - #05 no Dx ID175
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A 58-year-old man with a history of coronary artery disease presented with an ECG showing normal sinus rhythm of 88 beats per minute. The ECG revealed left bundle branch block, evidenced by a prolonged QRS duration of 145 milliseconds with characteristic morphology. Left bundle branch block can mask signs of left ventricular hypertrophy and prior myocardial infarction. It is also associated with secondary repolarization abnormalities like ST depression and negative T waves in leads with broad R waves. The final diagnosis was normal sinus rhythm with left bundle branch block.
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Stepwise interpretation of ECG ID175
This document summarizes the stepwise interpretation of an ECG for a 58-year-old man with coronary artery disease and left bundle branch block. It finds normal sinus rhythm at 88 beats per minute with visible P waves followed by QRS complexes at a constant PR interval of 140 milliseconds. The QRS duration is prolonged at 145 milliseconds, consistent with a pattern of left bundle branch block that can mask other conditions like left ventricular hypertrophy or myocardial infarction.
Stepwise interpretation of ECG ID175
A 58-year-old man with coronary artery disease was followed in the Cardiac Clinic. An electrocardiogram found normal sinus rhythm at 88 beats per minute with left bundle branch block, evidenced by a prolonged QRS duration of 145 milliseconds and abnormal depolarization that can mask other conditions.
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2. Atrial flutter is caused by reentry in the right and left atrium, presenting with rapid, regular P-waves at a rate of 250-400 BPM and an irregular ventricular response.
3. Atrial fibrillation is caused by multiple wavelets of reentry in the right and/or left atrium, with a heart rate over 400 BPM, irregular rhythm, and irregular ventricular response.
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This document summarizes the stepwise interpretation of an ECG for a 78 year old woman with a heart murmur. It finds sinus rhythm at 77 beats per minute with sinus arrhythmia and first degree AV block. The QRS axis and duration are normal with no signs of bundle branch blocks. There are findings of left ventricular hypertrophy with ST-T abnormalities indicating strain pattern. No signs of myocardial infarction are seen.
Stepwise interpretation of ECG - #06 no Dx ID168
This document summarizes the stepwise interpretation of an ECG for a 78 year old woman with a heart murmur. It finds sinus rhythm at 77 beats per minute with sinus arrhythmia and first degree AV block. The QRS axis and duration are normal with no signs of bundle branch blocks. There are findings of left ventricular hypertrophy with ST-T abnormalities indicating strain pattern. No signs of myocardial infarction are seen.
Stepwise interpretation of ECG - #06 no Dx ID168
A 78-year-old woman presented with a heart murmur. The ECG showed sinus rhythm at 77 beats per minute with sinus arrhythmia. There was first-degree AV block seen by a prolonged PR interval of 230 ms. Findings also included left ventricular hypertrophy with ST-T abnormalities consistent with left ventricular strain.
stepwise interpretation ECG #6
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.
Stepwise interpretation of ECG - #13 no Dx ID 419
Ectopic atrial rhythm at a rate of 75 beats per minute. P waves are clearly seen and negative in several leads, indicating they do not originate from the sinus node but likely a low atrial region. There is also an incomplete right bundle branch block present as shown by a prolonged QRS duration of 100 milliseconds with an rSR' pattern. The final diagnosis is an ectopic atrial rhythm at a rate of 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
Ectopic atrial rhythm at a rate of 75 beats per minute. P waves are clearly seen and negative in several leads, indicating they do not originate from the sinus node but likely a low atrial region. There is also an incomplete right bundle branch block present as shown by a widened QRS duration of 100 milliseconds with an rSR' pattern. The final diagnosis is an ectopic atrial rhythm at a rate of 75 beats per minute with an incomplete right bundle branch block.
Basics of ecg interpretation by dr sai
This document provides an overview of electrocardiogram (ECG or EKG) basics including:
- The 12 leads of a standard ECG and what each views of the heart
- Components of the ECG tracing including the P, Q, R, S, and T waves
- Methods for calculating heart rate from the ECG
- Identification and classification of common cardiac rhythms, arrhythmias, conduction abnormalities, chamber enlargements, and other ECG findings
- Interpretation of ECG findings in the context of underlying cardiac conditions, structures, or pathologies
cardiac arrhythmias
This document provides information on cardiac conduction systems, normal ECG rhythms, cardiac arrhythmias, and arrhythmia management. It defines normal sinus rhythm on ECG and describes the two main types of arrhythmias as bradycardia and tachycardia. Nine common arrhythmias are defined including atrial flutter, atrial fibrillation, junctional rhythm, and various ventricular arrhythmias. Treatment options for arrhythmias include electrical cardioversion, antiarrhythmic medications, and pacemakers.
ECG Rhythm abnormality for undergraduates
The rhythm is best analyzed by looking at a rhythm strip.
On a 12 lead ECG this is usually a 10 second recording from Lead II.
Confirm or corroborate any findings in this lead by checking the other leads.
A longer rhythm strip, recorded perhaps recorded at a slower speed, may be helpful.
Arrhythmias
Heart arrhythmia, also known as irregular heartbeat or cardiac dysrhythmia, is a group of conditions where the heartbeat is irregular, too slow, or too fast. Arrhythmias are broken down into: Slow heartbeat: bradycardia. Fast heartbeat: tachycardia. Irregular heartbeat: flutter or fibrillation.
Stepwise interpretation of ECG - #14 no Dx ID123
A 67-year-old woman presented with palpitations. Her ECG showed a narrow-QRS tachycardia at a rate of 160 beats per minute. P waves were visible and preceded the QRS complexes, with negative P waves in leads II, III, aVF, and V3-V6. The PR interval was 140 milliseconds. Based on these characteristics, the patient was diagnosed with atrial tachycardia. Additional analysis found a normal QRS axis and duration, no ventricular hypertrophy, no signs of infarction, and normal T waves.
Stepwise interpretation of ECG - #13 no Dx ID419
The ECG shows an ectopic atrial rhythm originating from a low atrial region at a rate of 70 beats per minute, as well as an incomplete right bundle branch block. P waves are abnormal in shape and timing. There are no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves.
ECG #13 - ID 419 - EAR IRBBB
This ECG shows an ectopic atrial rhythm originating from a low atrial region at a rate of 70 beats per minute, as well as an incomplete right bundle branch block. P waves are clearly seen and negative in several leads, with a PR interval of 180ms indicating the rhythm is not junctional. The QRS axis is normal and duration is 100ms with an rSR' pattern consistent with incomplete right bundle branch block. The final diagnosis is an ectopic atrial rhythm at 70bpm with incomplete right bundle branch block.
Similar to Stepwise interpretation of ECG - #05 no Dx ID175 (20)
More from Anas Nader
ECG #14 - ID 123 - Atrial Tachycardia
A 67-year-old woman presented with palpitations. An ECG showed a narrow-QRS tachycardia at a rate of 160 beats per minute, with visible P waves preceding each QRS complex. The P waves were negative in leads II, III, aVF and V3-V6, with a PR interval of 140 msec. Based on these characteristics, the patient was diagnosed with atrial tachycardia originating from the atria.
ECG #12 - ID 111 - CHB
This document discusses the stepwise interpretation of an ECG for a patient. It identifies that the patient, a 56-year-old man who had an episode of syncope, has sinus rhythm with complete heart block. The atrial rate is 80/min while the ventricular rate is 43/min, showing dissociation between the two rhythms. The QRS complexes originate from the AV junction at a rate of 43/min, indicating an escape junctional rhythm. The final diagnosis is sinus rhythm with complete heart block and an escape junctional rhythm supplying the ventricles.
ECG #11 - ID 108 - 2nd degree AV block
This document summarizes the ECG findings for a 58-year-old man presenting to the emergency department with 2nd degree AV block, Mobitz type 1. The ECG shows regular sinus rhythm at a rate of 88 beats per minute with intermittent conduction block such that every third P-wave is not followed by a QRS complex, resulting in a ventricular rate of 59 beats per minute. Further analysis of the ECG found normal QRS axis, duration and morphology with no signs of infarction, hypertrophy, or other abnormalities. The final diagnosis was sinus rhythm with Mobitz type 1 2nd degree AV block and a ventricular rate of 58 beats per minute.
ECG #10 - ID122 - Atrial Flutter
This document describes the stepwise interpretation of ECG ID 122, which shows atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute in a 50-year-old man complaining of palpitations. The interpretation examines the P waves, QRS complex, QRS duration, signs of ventricular hypertrophy or myocardial infarction, and T waves. The final diagnosis is atrial flutter with variable AV block and a ventricular rate of 107 beats per minute.
ECG #9 - ID594a - acute ASMI
This ECG shows signs of an acute antero-septal myocardial infarction in a 49-year old man presenting with chest pain, requiring urgent therapy. The ECG reveals normal sinus rhythm, a normal QRS axis and duration, and marked ST elevation in leads V1-V4, consistent with an antero-septal injury pattern diagnostic of an acute antero-septal infarction.
ECG #7 - ID 279 - RVH
This ECG belongs to a 57-year-old woman with a history of rheumatic fever and recent symptoms of severe dyspnea and fatigue. The ECG shows normal sinus rhythm, left atrial enlargement, right axis deviation, and right ventricular hypertrophy. There are also ST depressions and negative T waves that may indicate ischemia from heart failure.
ECG #2 - ID 352 - Premature Atrial Complexes
A 62-year-old man presented with palpitations. An analysis of his ECG found sinus rhythm at 83 bpm with premature atrial complexes, where every third P wave was premature in a pattern of trigeminy. The QRS complexes, ST segments, and T waves were normal with no signs of right or left atrial enlargement, bundle branch blocks, ventricular hypertrophy, or myocardial infarction. The final diagnosis was sinus rhythm with atrial premature complexes in a pattern of trigeminy, but an otherwise normal ECG.
ECG #1 - ID 380 – Normal ECG
The ECG is for a 53-year-old man undergoing pre-anesthesia evaluation. The interpreter found normal sinus rhythm at a rate of 60 bpm, normal P waves and PR interval, normal QRS axis and duration with no evidence of conduction blocks, no signs of chamber enlargement or hypertrophy, and normal ST segments and T waves. The final diagnosis was a normal ECG.
ECG #4 - ID 383 – Atrial fibrillation
A 76-year-old woman underwent an ECG examination in her family doctor's office which showed atrial fibrillation with an irregularly irregular ventricular rhythm of 66 beats per minute and no P waves. The QRS complexes were normal with no signs of conduction abnormalities, ventricular hypertrophy, or prior myocardial infarction. The final diagnosis was atrial fibrillation with a controlled ventricular rate of 66 bpm and no other abnormalities.
ID 352 –Sinus rhythm With premature atrial complex
A 62-year-old man presented with palpitations. An analysis of his ECG found sinus rhythm at 83 bpm with premature atrial complexes, where every third P wave was premature in a pattern of trigeminy. The ECG further showed normal P waves, QRS axis, duration and complexes, as well as normal ST segments and T waves. The final diagnosis was sinus rhythm with atrial premature complexes in a pattern of trigeminy, but an otherwise normal ECG.
Atrio-ventricular dissociation
Atrio-ventricular dissociation occurs when the atrial and ventricular rhythms are independent of each other. It can happen when the atrial rate slows below the intrinsic ventricular rate, or due to inappropriate acceleration of the ventricular rate. Typically in AV dissociation the distal pacemaker, such as the ventricles, beats faster than the proximal pacemaker like the atria. In complete heart block the proximal pacemaker usually beats faster than the distal one. However, there are exceptions to using pacemaker rates to distinguish the two.
Lead errors: reversal of limb leads
This document discusses common errors involving limb leads in electrocardiograms (ECGs), including:
1) Lead reversal is a common error, such as switching the right and left arm leads. This can cause leads like aVR and aVL to be reversed.
2) Misplacing the ground cable, such as attaching it to the right arm instead of the right leg, is another error.
3) Complex misplacements of the limb leads are less common. Examples provided demonstrate how specific lead errors can cause abnormalities to appear or disappear on ECG tracings.
Stepwise interpretation of ECG - #9 no Dx ID 594
This ECG shows a 49-year-old man experiencing severe chest pain for 1 hour who is presenting with an antero-septal injury pattern consistent with an acute myocardial infarction requiring urgent therapy. The ECG shows normal sinus rhythm at 84 beats per minute, a normal PR interval and QRS axis, and no signs of ventricular hypertrophy. It does reveal marked ST elevation in leads V1-V4, confirming the diagnosis of an acute antero-septal infarction.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm originating outside the sinoatrial node at a rate of 75 beats per minute. The P waves precede each QRS complex but have an abnormal axis. There is also evidence of incomplete right bundle branch block seen by a widened QRS complex with a duration of 100 milliseconds and rSR' pattern. The final diagnosis is an ectopic atrial rhythm at 75 bpm with incomplete right bundle branch block and no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm at a rate of 70 beats per minute with an incomplete right bundle branch block pattern. The QRS axis is normal and the duration is 100 msec. with an rSR' configuration. There are no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves. The final diagnosis is an ectopic atrial rhythm at 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm at a rate of 70 beats per minute with an incomplete right bundle branch block pattern. The QRS axis is normal and the duration is 100 msec. with an rSR' configuration. There are no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves. The final diagnosis is an ectopic atrial rhythm at 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #12 no Dx ID 111
A 56-year-old man presented with an episode of syncope. An ECG was performed which showed sinus rhythm with complete heart block, where the atrial rate was 80/min and the ventricular rate was 43/min. The dissociation of the P waves and QRS complexes along with the narrow QRS escape rhythm indicated the ventricular activation was coming from the AV junctional area. The ECG was otherwise normal.
Stepwise interpretation of ECG - #14 no Dx ID123
A 67-year-old woman presented with palpitations. Her ECG showed a narrow-QRS tachycardia of 160 beats per minute. P waves were visible and preceded the QRS complexes, with a PR interval of 140 msec. The arrhythmia was diagnosed as atrial tachycardia based on the P wave morphology and timing.
Stepwise interpretation of ECG - #12 no Dx ID111
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape rhythm was originating from the AV junction. The final diagnosis was sinus rhythm with complete heart block and an escape junctional rhythm at a ventricular rate of 43/min.
Stepwise interpretation of ECG - #12 no Dx ID111
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape pacemaker was in the AV junction, resulting in an escape junctional rhythm controlling the ventricles. The ECG was otherwise normal.
More from Anas Nader (20)
ID 352 –Sinus rhythm With premature atrial complex
ID 352 –Sinus rhythm With premature atrial complex
Stepwise interpretation of ECG - #05 no Dx ID175
- 1. Stepwise interpretation of ECG ID 175
- 2. ID 175 – 58 year old man followed in the Cardiac Clinic because of coronary artery disease
- 3. ID 175 – 58 year old man followed in the Cardiac Clinic because of coronary artery disease Can you see P waves?
- 4. ID 175 – Normal sinus rhythm, 88/min. Yes. There is sinus rhythm, 88/min. Each P is followed by a QRS complex, with a constant P- R interval (140 msec)
- 5. ID 175 – Normal sinus rhythm, 88/min. There are no signs of right or left atrial enlargement
- 6. ID 175 Normal Sinus rhythm, 88/min. Left bundle branch block The QRS duration is prolonged (145 msec.), with a pattern of Left Bundle Branch Block (LBBB)
- 7. ID 165 Normal Sinus rhythm, 88/min. Left bundle branch block The presence of LBBB may mask the diagnosis of left ventricular hypertrophy and/or myocardial infarction
- 8. ID 165 Normal Sinus rhythm, 88/min. Left bundle branch block In left bundle branch block the abnormal depolarization is usually associated with secondary abnormal repolarization (ST depression and negative T in the leads showing a broad R wave)
- 9. ID 165 Final diagnosis: Normal Sinus rhythm, 88/min. Left bundle branch block
- 10. ID 165 Final diagnosis: Normal Sinus rhythm, 88/min. Left bundle branch block