ECG Analysis Report

• Speed: 25 mm/sec
• Limb gain: 10 mm/mV
• Chest gain: 10.0 mm/mV
• Filter: F 50 - 0.15-100 Hz
• Calibration: 100B

Printed Machine Measurements (from left panel)

Systematic Lead-by-Lead Interpretation

Rhythm & Rate

• Rate: Approximately 70-75 bpm (regular R-R intervals)
• Rhythm: Regular sinus rhythm - P waves are upright and consistent in leads I, II, and aVF

Intervals

• PR interval: 180 ms - at the upper limit of normal (normal: 120-200 ms). Not prolonged enough to diagnose 1st-degree AV block, but borderline.
• QRS duration: 90 ms - normal (< 120 ms), no bundle branch block
• QT: 373 ms / QTc: 403 ms - QTc is within normal range (< 440 ms in men, < 460 ms in women)

Axis

• Axis approximately -13° - borderline left axis deviation (normal: -30° to +90°). Just within or at the edge of normal; no pathological left axis deviation.

P Waves

• Upright in I, II - consistent with sinus origin
• No obvious P-wave abnormality noted

QRS Morphology

• Lead I: Upright QRS with reasonable amplitude
• Lead II: Positive QRS, upright T waves
• Lead III: Smaller amplitude, variable morphology (consistent with axis)
• aVR: Negative QRS (as expected)
• aVL: Small or biphasic - consistent with borderline left axis
• aVF: Upright QRS

• V1: rS pattern with relatively small R wave - normal
• V2: Predominantly negative (rS) - transitioning
• V3: Transition zone
• V4: R wave becoming more prominent - normal R-wave progression
• V5: Tall R wave with upright T wave
• V6: Tall R wave

ST Segments

• No definitive ST elevation or depression is visible at this image resolution
• ST segments appear isoelectric across limb and precordial leads
• No obvious acute ischemic changes identified

T Waves

• T waves appear upright in I, II, V4-V6
• No obvious T-wave inversion in lateral leads
• Inverted or flat T waves cannot be confidently excluded in V1-V3 (physiologically normal in V1-V2)

Summary / Interpretation

Clinical Impression

1. A borderline PR interval (180 ms) - warrants correlation with symptoms; if symptomatic (e.g., near-syncope, fatigue), 24-hour Holter monitoring may be considered to rule out higher-degree AV blocks
2. Borderline left axis - a non-specific finding; differential includes left anterior fascicular block (LAFB), inferior MI (old), or normal variant especially in obese or pregnant individuals
3. No acute ischemic changes identified on this tracing

Important Disclaimer: This is an educational/informational ECG analysis based on the available image. ECG interpretation must always be performed and confirmed by a qualified physician or cardiologist in the context of the patient's clinical presentation, symptoms, history, and other investigations. This report does not constitute a medical diagnosis or replace professional medical advice. If you or the patient are experiencing chest pain, shortness of breath, palpitations, or syncope, seek immediate medical attention.

ST Elevation Assessment

Answer: No definitive ST elevation is present on this ECG.

Important caveats

1. Image quality and angle - the ECG is photographed at a slight angle and the resolution limits fine measurement. A dedicated digital trace or physical ruler measurement would be more definitive.
2. STEMI criteria for reference - ST elevation is considered significant when:
   • ≥ 1 mm in 2 or more contiguous limb leads
   • ≥ 2 mm (men) / ≥ 1.5 mm (women) in V2-V3
   • ≥ 1 mm in 2 or more contiguous precordial leads
3. No reciprocal ST depression is visible either, which would typically accompany a STEMI in the mirror-image leads.