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Diagnosis
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ECG Interpretation - 6-year-old Female (Maha)
Machine Report Summary
- Heart Rate: 87 bpm
- PR interval: 134 ms
- QRS duration: 104 ms
- QTc: 467 ms
- P-R-T Axes: 63° / 28° / 47°
- Machine conclusion: Normal Sinus Rhythm, Normal Axis, Normal ECG
My Analysis
The machine reads this as normal, and overall the tracing is largely within normal limits for a 6-year-old child, but there are a few findings worth noting:
Normal findings for this age:
- Normal sinus rhythm at 87 bpm
- Normal frontal axis (QRS axis 28°)
- Upright P waves in leads I, II, aVF - confirming sinus origin
- rS pattern in V1-V2 (right ventricular dominance is normal in children)
- T-wave inversion in V1-V3 - this is the juvenile T-wave pattern, a normal variant in children up to adolescence
- Narrow QRS (104 ms), no bundle branch block
One flag worth physician attention:
- QTc of 467 ms - this is mildly prolonged. Normal upper limit in children is typically 440-450 ms (some sources cite 460 ms in females). At 467 ms, this sits in a borderline zone.
- This may be a normal variant, but should be correlated clinically (symptoms of syncope, palpitations, family history of sudden cardiac death or congenital long QT syndrome)
- If symptomatic, a repeat ECG and possible cardiology referral is appropriate
Diagnosis
Normal Sinus Rhythm with Juvenile T-wave Pattern (normal for age) Borderline QTc prolongation (467 ms) - requires clinical correlation
The T-wave inversions in V1-V3 are not a sign of ischemia in a 6-year-old - they are expected and normal. The main actionable finding is the mildly elevated QTc, which should prompt a clinical history review for symptoms and family history before dismissing entirely.
⚠️ This interpretation is for educational purposes. All ECGs must be confirmed by a qualified physician.
Ok
Understood! Let me know if you have any other ECGs, images, or questions you'd like help with.
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