12-Lead ECG Analysis Report

• Paper speed: 25 mm/s
• Gain: 10 mm/mV
• Format: Sequential (3-channel display)
• Printed: 13/02/2026, 11:16:32

Machine-Measured Intervals (from header)

Systematic ECG Interpretation

1. Rate

• Approximately 59 bpm - at the lower end of normal (borderline bradycardia / low-normal sinus rate)

2. Rhythm

• Regular rhythm
• P waves are present and upright in lead II - consistent with normal sinus rhythm

3. Axis

• QRS axis appears approximately +30 to +40° - Normal axis

4. P Waves

• Present and upright in leads I, II, aVF
• Inverted in aVR (normal)
• PR interval ~160-170 ms - within normal limits (120-200 ms)

5. QRS Complex

• Duration ~111 ms - this is borderline prolonged (upper limit of normal is 120 ms, so still within acceptable range but approaching broad)
• No frank bundle branch block pattern
• Transition zone appears around V3-V4 (normal)

6. ST Segments & T Waves

• In leads V4-V6: there appear to be shallow T-wave changes - the T waves look relatively flat or biphasic in the precordial leads
• In lead V1: rS morphology (normal)
• No frank ST elevation or depression is clearly identified
• aVR: negative QRS and T (normal)

7. QT/QTc

• QTc ~450 ms - this is at the upper limit of normal (borderline prolonged; concern threshold is >450 ms in men, >460 ms in women)

8. Notable Findings

• The QRS appears relatively low in voltage across the limb leads
• Lead III shows a somewhat deeper morphology compared to lead I and II
• The precordial leads V4-V6 show relatively flat or inverted T waves - this warrants attention

Summary Interpretation

1. Sinus rhythm at ~59 bpm (low-normal / borderline bradycardia)
2. Normal axis (~+30-40°)
3. Borderline QRS duration (~111 ms) - not meeting full LBBB/RBBB criteria
4. Borderline QTc (~450 ms) - at upper limit of normal; should be monitored, especially if the patient is on QT-prolonging medications
5. T-wave flattening in precordial leads (V4-V6) - non-specific, but could suggest:
   • Ischemia (lateral wall)
   • Electrolyte abnormality (hypokalemia, hypomagnesemia)
   • LVH with strain
   • Medications (digoxin, antiarrhythmics)
   • Normal variant (less likely given distribution)

Clinical Correlation Required

Important: This ECG analysis is based on visual interpretation of a photographed tracing. Image quality and rotation limit precision. The following should be correlated clinically:

• Symptoms: Chest pain, dyspnea, palpitations, syncope?
• Risk factors: Hypertension, diabetes, smoking, prior cardiac history?
• Medications: Any QT-prolonging drugs?
• Electrolytes: K⁺, Mg²⁺ levels?
• Prior ECGs for comparison (new changes vs. baseline)?