ECG Interpretation

Automated Measurements (from the printed data panel)

ST Level Table (mm)

Key Findings

1. Bradycardia - Heart rate of 46 bpm (normal: 60-100 bpm). This is significant sinus bradycardia.
2. Short PR interval - 110 ms (normal: 120-200 ms). A PR < 120 ms raises consideration of:
   • Pre-excitation (WPW pattern) - look for delta waves
   • Junctional rhythm
   • Enhanced AV nodal conduction (Lown-Ganong-Levine syndrome)
3. Axis - P-axis 75°, QRS axis 89°, T-axis 81° - all within normal range (normal QRS axis: -30° to +90°).
4. QRS duration - 75 ms - narrow, normal.
5. QTc 348 ms - Normal (borderline short; normal 350-450 ms for males).
6. ST changes noted:
   • III shows -0.47 mm (minor, likely non-significant)
   • aVR shows +0.34 mm (subtle elevation)
   • Most other leads show trivial deviation close to baseline
7. The machine has flagged this as "Abnormal ECG" (printed at the bottom of the report).

Automated Interpretation Labels Visible

• Sinus Bradycardia (most likely given rate of 46 and visible P waves)
• Short PR / possible pre-excitation pattern
• The label at V2.27 reads "Tachycardia" in the printout - this is likely an artifact notation or algorithm error, as the rate is clearly bradycardic at 46 bpm; some automated systems mislabel ectopic beats

Clinical Summary

Clinical Recommendation

• Correlate clinically - bradycardia at 46 bpm may be physiological in a young, fit military individual (athlete's heart) or pathological if symptomatic (dizziness, syncope, fatigue).
• The short PR interval warrants a 12-lead review for delta waves to exclude Wolff-Parkinson-White (WPW) syndrome.
• If symptomatic bradycardia: consider Holter monitoring and electrophysiology referral.
• No acute ischemic changes are evident from the ST data.

Note: This interpretation is based on visible measurements and waveform data. A full waveform review by a cardiologist is recommended for clinical decision-making.