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ECG Interpretation

Patient & Machine Data

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Machine Conclusion (Auto-interpretation)

1. Sinus Tachycardia (code 803)
2. Mild Left Axis Deviation (code 202)
3. Low Voltage - Limb Leads (code 131)
4. Clockwise Rotation (code 121)

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Finding-by-Finding Breakdown

1. Sinus Tachycardia (HR 103 bpm)

• Sinus rhythm is confirmed: P waves are present with a normal P-axis of 49°, meaning atria are depolarizing in the normal direction.
• Rate of 103 bpm is mildly above the normal upper limit of 100 bpm.
• Clinical significance: Sinus tachycardia is almost always a secondary phenomenon. Common causes include fever, pain, anxiety, dehydration, anemia, hyperthyroidism, or cardiopulmonary disease. The underlying cause needs to be identified.

2. Mild Left Axis Deviation (QRS axis -17°)

• Normal QRS axis is -30° to +90°. An axis of -17° is technically within the leftward-normal zone but trending left.
• The machine labels it "mild" - this is appropriate. True Left Axis Deviation (LAD) would be more negative than -30°.
• Causes to consider: Left anterior fascicular block (LAFB), inferior MI (old), LVH, or a normal variant (especially in obese or short individuals).

3. Low Voltage in Limb Leads

• Low voltage = QRS amplitude < 5 mm in all limb leads.
• Causes: Pericardial effusion, obesity, COPD/emphysema, hypothyroidism, myocardial infiltration (amyloid, sarcoid), or dilated cardiomyopathy.
• This is an important finding that warrants clinical correlation - particularly if the patient has no obvious reason (like obesity or COPD), an echocardiogram should be considered to rule out pericardial effusion or cardiomyopathy.

4. Clockwise Rotation

• On precordial leads, the transition zone (where R = S) shifts later than normal (usually in V3-V4), moving toward V5-V6.
• Associated with: COPD, right ventricular enlargement, or a normal variant. Combined with low voltage in limb leads, COPD is worth considering.

5. QTc 416 ms

• This is borderline (upper limit of normal is 440 ms in males). No immediate concern, but worth monitoring especially if the patient is started on QT-prolonging drugs.

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Summary & Clinical Recommendations

• The sinus tachycardia needs a clinical explanation - check for fever, pain, anxiety, thyroid function, anemia, or hemodynamic instability.
• The low voltage + clockwise rotation combination is a classic hint toward COPD/emphysema or pericardial effusion - an echocardiogram would be informative.
• The mild left axis deviation is not alarming alone but should be noted.
• No ST elevation, no ST depression, no pathological Q waves, and no bundle branch block are identified - so there is no acute ischemia/infarction pattern on this ECG.

⚠️ The machine printout itself states: "The result must be confirmed by a doctor." This ECG analysis is for educational purposes and does not replace clinical judgment.