identify
Reading File
This is an ECG (electrocardiogram) printout from VNS Memorial Institute of Medical Sciences, along with other patient documents. Let me analyze the ECG in detail.
ECG Identification & Analysis
Document Details
- Institution: VNS Memorial Institute of Medical Sciences (NABH Accredited)
- ID: 1700001853
- Date: 01-01-2011 (likely a placeholder/default date)
- Speed: 25 mm/s | Gain: 20 mm/mV
- Leads visible: I, II, III, aVR, aVL, aVF, V1–V6 (standard 12-lead ECG)
Recorded Parameters (from bottom strip)
| Parameter | Value |
|---|---|
| HR | 107 bpm |
| PR | 100 ms |
| QRS | 154 ms |
| QT/QTc | 333/445 ms |
| P/QRS/T axis | 101/82/85° |
| RV5+SV1 | 1.6/0.466 mV |
ECG Interpretation
Rate & Rhythm
- Heart rate: 107 bpm → Sinus tachycardia
- Rhythm appears regular
Conduction
- QRS duration: 154 ms → Significantly prolonged (normal <120 ms) — indicates bundle branch block (BBB)
- PR interval: 100 ms → Short-normal
- QTc: 445 ms → Borderline prolonged
Axis
- P-axis: 101° — right axis deviation
- QRS axis: 82° — normal
- T-axis: 85° — normal
Machine Diagnosis (printed at bottom)
"Sinus Rhythm, Arm Leads Reversed... Normal ECG"
⚠️ Note: The machine labels it "Normal ECG" but the QRS of 154 ms is abnormal and suggests either:
- Left Bundle Branch Block (LBBB) — broad, notched R waves in lateral leads (I, aVL, V5–V6) with no septal Q waves
- Right Bundle Branch Block (RBBB) — RSR' pattern in V1, wide S in lateral leads
The machine also flagged "Arm Leads Reversed" — meaning the limb lead placement may be incorrect, which can produce artifactual axis changes and affect the morphology of leads I, II, III, aVR, aVL, aVF.
Associated Documents
The surrounding papers include:
- Lab requisition form — CBC, ESR, Retic Count, AEC, GBP, urine, semen analysis ordered
- Ultrasound report — Impression mentions: "Non-peristaltic tubular non-compressible structure in right iliac fossa with surrounding fat echogenicity — appendicitis... Adv: CECT" → Suggesting acute appendicitis, confirmed by the radiologist advising a contrast CT
- Clinical notes — Chief complaints include chest pain, headache; BP noted
Summary
| Finding | Interpretation |
|---|---|
| Sinus tachycardia (107 bpm) | Possible pain/anxiety/sepsis response |
| Wide QRS (154 ms) | Bundle branch block |
| Arm leads reversed | Limb lead misplacement artifact |
| USG → appendicitis suspected | Right iliac fossa non-compressible tubular structure |
This patient appears to be presenting with right iliac fossa pain (likely appendicitis) and has an incidental or clinically relevant finding of a wide-complex tachycardia / bundle branch block on ECG.
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