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ECG interpretation early repolarization right axis deviation young male normal variant
Here is a complete, detailed analysis of this ECG:
ECG Analysis - Global Speciality Hospital
Patient & Administrative Details
- Patient: Mr. Rishu, Age 23, Male
- ID: 23
- Date/Time: 23/05/2026, 11:14:35 AM
- Hospital: Global Speciality Hospital, Infront Akashwani, Behind Hotel Sita Manor, Gandhi Road, Gwalior (M.P.) 474002
- Report Type: Raw ECG - (UNCONFIRMED REPORT)
- Speed: 25 mm/sec
- Sensitivity: 10 mm/mV
Machine-Calculated Parameters
| Parameter | Value |
|---|---|
| Rate | 83 bpm |
| P Axis | 43 degrees |
| QRS Axis | 75 degrees |
| T Axis | 35 degrees |
| P Duration | 89 ms |
| QRS Duration | 79 ms |
| QT Interval | 340 ms |
| QTc Interval | 380 ms |
Rhythm Analysis
- Rate: 83 bpm - normal sinus rate (60-100 bpm)
- Rhythm: Regular sinus rhythm
- P waves: Present before every QRS; P axis 43 degrees = normal (upright in I, II, aVF)
- PR interval: Appears normal (approximately 120-200 ms range visually)
Axis Interpretation
- QRS Axis: 75 degrees - completely normal (normal range: -30 to +90 degrees)
- P Axis: 43 degrees - normal
- T Axis: 35 degrees - normal, concordant with QRS axis
Interval Analysis
- QRS Duration: 79 ms - Normal (< 120 ms). No bundle branch block.
- QT Interval: 340 ms - Normal
- QTc: 380 ms - Normal (normal < 440 ms in males). No prolonged QT.
Lead-by-Lead Waveform Analysis
Limb Leads:
| Lead | Observations |
|---|---|
| I | Upright QRS, normal morphology |
| II | Upright P, QRS, T - classic sinus rhythm lead; normal |
| III | QRS visible; possible small Q or biphasic morphology - can be normal variant |
| aVR | Predominantly negative QRS (expected and normal - aVR is the "opposite" lead) |
| aVL | Small/isoelectric or biphasic QRS (expected at QRS axis of 75 degrees, which is nearly perpendicular to aVL at ~-30 degrees) |
| aVF | Upright QRS (expected with axis of +75 degrees) |
Precordial Leads:
| Lead | Observations |
|---|---|
| V1 | Predominantly negative (rS pattern) - normal for V1 |
| V2 | Tall R or prominent QRS - consistent with normal septal activation + young male with thin chest wall |
| V3 | Transitional zone; normal R wave progression beginning |
| V4 | Continuing R wave progression |
| V5 | Tall R waves - common in young males, not pathological in isolation |
| V6 | Terminal upright QRS morphology; normal lateral lead |
R Wave Progression: Normal - R waves increase from V1 to V5/V6. Transition zone appears normal (between V3-V4).
Notable Findings
-
Voltage: The QRS complexes appear relatively prominent in precordial leads - this is a normal variant in a 23-year-old male with a thin chest wall (increased voltage is common in young, lean individuals).
-
ST Segments: No significant ST elevation or depression visible. The tracing does not suggest acute ischemia or injury.
-
T Waves: Appear upright in lateral leads. T-wave inversions in V1-V2 can be a normal juvenile T-wave pattern in a 23-year-old.
-
No Delta Waves: No pre-excitation pattern (no slurred upstroke of QRS) - no evidence of WPW.
-
No Bundle Branch Block: QRS duration 79 ms is well within normal limits.
-
QTc 380 ms: No prolonged QT. No risk for torsades de pointes based on this alone.
Overall Impression
Normal ECG for a 23-year-old male.
All machine-calculated parameters (rate, axis, intervals, durations) are within normal reference ranges. The QRS axis of 75 degrees is normal. QTc of 380 ms is normal. No evidence of:
- Ischemia or infarction (no ST changes, no pathological Q waves)
- Arrhythmia (regular sinus rhythm at 83 bpm)
- Conduction disease (normal PR, normal QRS duration)
- Chamber hypertrophy (no criteria met, though voltage appears prominent - this is age-appropriate)
- Pre-excitation (no delta waves)
The prominent precordial voltages seen are typical for a young, presumably lean 23-year-old male and do not warrant concern without clinical symptoms.
Important note: This report is marked "UNCONFIRMED REPORT" on the tracing, meaning it has not yet been reviewed and signed by a physician at the time of printing. The machine interpretation is a guide only. A cardiologist or treating physician must confirm the final interpretation in clinical context.
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