ECG Analysis — Patient Details

Automated Measurements (from the printout)

Manual Interpretation

1. Rhythm

• Sinus tachycardia — Rate is 114 bpm, which is above the normal upper limit of 100 bpm. The machine calls it "sinus rhythm," but the rate qualifies as sinus tachycardia.
• Regular rhythm with P waves preceding each QRS complex.

2. PR Interval — 110 ms ⚠️

• This is short (normal ≥120 ms). A PR interval <120 ms can suggest:
  • Pre-excitation (e.g., WPW syndrome — look for delta waves on the upstroke of QRS)
  • AV nodal/junctional acceleration
  • Occasionally a normal variant in tachycardia
• The tracing should be carefully reviewed for delta waves in V1–V6 and lateral leads.

3. QRS — 89 ms

• Narrow QRS — normal ventricular conduction. No bundle branch block.

4. QTc — 460 ms ⚠️ (Borderline prolonged)

• Normal QTc for females is <450–460 ms. A QTc of 460 ms sits at the upper limit of normal and should be monitored, especially if the patient is on QT-prolonging medications (e.g., antibiotics, antipsychotics, antiarrhythmics).

5. Axis

• QRS axis: –13° — This is in the left axis deviation (LAD) range (normal is 0° to +90°). Mild LAD can be seen with left anterior fascicular block, LVH, or inferior MI. The degree here is mild.

6. Precordial Leads (V1–V6)

• R-wave progression should be assessed. Normal progression is small r in V1 growing to dominant R by V5–V6.

7. ST Segments & T Waves

• The machine reports a normal ECG — no overt ST elevation or pathological Q waves flagged.

Summary of Key Findings

Clinical Recommendations

1. Investigate the cause of tachycardia — check vitals, temperature, thyroid function, hydration status, and clinical history.
2. Evaluate for pre-excitation — the short PR (110 ms) warrants scrutiny of the QRS upstroke for delta waves across all 12 leads. If WPW is confirmed, electrophysiology referral may be needed.
3. Check electrolytes (K⁺, Mg²⁺, Ca²⁺) and review the medication list for QT-prolonging drugs given the borderline QTc.
4. Repeat ECG when the patient is at rest/euvolemic if tachycardia is rate-related, as some findings (short PR, axis deviation) may look different at a lower heart rate.

⚠️ Disclaimer: This analysis is for educational and supportive purposes only. All ECG interpretations must be confirmed by a qualified clinician in the context of the patient's full clinical picture.