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analyse the ecg
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ECG Analysis Report
Patient: Female, 10 years old, 20 kg
Settings: Paper speed 25 mm/s | Gain 10 mm/mV | LP: 40 Hz, AC: 50 Hz
Rhythm & Rate
- Rhythm: Normal Sinus Rhythm
- Heart Rate: 87 bpm (machine-reported; visually confirmed by R-R interval ~3.5 large boxes = ~86 bpm)
- Regular P waves precede every QRS; P waves upright in I, II, aVF; inverted in aVR (normal)
Intervals
| Parameter | Measured | Normal (pediatric) |
|---|---|---|
| PR interval | ~140 ms | 120-200 ms ✓ |
| QRS duration | ~80 ms | <100 ms ✓ |
| QTc | Visually normal | <440 ms ✓ |
Axis
- Lead I: positive | Lead aVF: positive
- Normal axis (0° to +90°)
QRS Morphology
- R-wave progression: Normal across V1-V6
- V1: rS pattern (normal for age)
- Transition zone at V3-V4 (normal)
- No LVH (does not meet Sokolow-Lyon criteria)
- No RVH (no dominant R in V1, no right axis deviation)
ST Segment & T Waves
- ST segments isoelectric in all 12 leads - no elevation or depression
- T waves upright in I, II, aVL, aVF, V2-V6
- T inversion in aVR (physiologically normal)
- No hyperacute T waves, no flattening, no deep inversions
- No pathological Q waves
Conclusion
Normal 12-lead ECG for a 10-year-old female.
No evidence of:
- Acute ischemia or infarction
- Bundle branch block or conduction abnormality
- Chamber hypertrophy
- Arrhythmia
- QT prolongation
Disclaimer: This is an AI-assisted interpretation for educational/screening purposes. All ECG readings should be reviewed and confirmed by a qualified cardiologist or clinician, especially in a pediatric patient.
20260709_053523859.jpg
find the ecg abnormality
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Finding Sources
Here is the focused abnormality-targeted analysis:
ECG Abnormality Findings - 10-Year-Old Female (Shubham, 10/F)
Key Finding: Respiratory Sinus Arrhythmia
The primary abnormality (and the one noted in the handwritten annotation "Sinus Arrh") is sinus arrhythmia - there is mild but visible cyclic variation in the R-R intervals. This represents the normal physiologic speeding up of the heart during inspiration and slowing during expiration, mediated by the vagus nerve. In a 10-year-old, this is the most common and expected ECG finding - it is more prominent in children than adults.
Important Technical Note - Split Calibration
The printout reads "10.0/5.0 mm/mV" - this is a split calibration:
- Limb leads (I, II, III, aVR, aVL, aVF): Standard 10 mm/mV
- Chest leads (V1-V6): Half-standard 5 mm/mV
This means any voltage measurement in V1-V6 must be doubled for the true value. This is done routinely in pediatric ECGs to prevent overlapping of tall QRS complexes.
Systematic Search for Abnormalities
| Feature | Finding | Verdict |
|---|---|---|
| Rhythm | Sinus with R-R variability | Sinus arrhythmia (normal variant in child) |
| Rate | 87 bpm | Normal |
| P wave axis | Upright I, II, aVF; inverted aVR | Normal |
| PR interval | ~120 ms, constant | Normal - no pre-excitation/WPW |
| Delta waves | Absent | No WPW |
| QRS duration | ~80 ms, narrow | No bundle branch block |
| QRS axis | Normal (positive I and aVF) | No right or left axis deviation |
| V1 morphology | rS pattern | Normal for age - no RVH |
| T inversion V1 | Present | Normal juvenile T-wave pattern |
| T waves V2-V4 | Upright | Normal transition for 10-year-old |
| ST segments | Isoelectric all leads | No ischemia |
| QTc | ~430 ms | Normal (<460 ms for females) |
| Voltages (corrected) | Within normal limits | No LVH or RVH |
| Q waves | None pathological | Normal |
Conclusion
The only abnormality present is respiratory sinus arrhythmia - which is actually a normal physiological variant in a 10-year-old child, driven by increased vagal tone. The clinician's handwritten note also reflects this interpretation ("Sinus Arrh").
Other findings worth noting:
- Juvenile T-wave pattern (T inversion in V1) - normal in children up to adolescence
- Half-standard chest lead calibration - important when calculating voltages
There are no pathological abnormalities such as WPW, bundle branch block, hypertrophy, ischemia, long QT, or congenital heart disease pattern on this tracing.
Disclaimer: ECG interpretation must always be confirmed by a qualified cardiologist. AI analysis is for educational and screening support only.
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