IMG_20260728_202733.jpg
Interpret this ecg
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Reading File
Here is a full systematic interpretation of this ECG:
ECG Interpretation
Machine-Printed Measurements
| Parameter | Value |
|---|---|
| Heart Rate | 101 bpm |
| P duration | 100 ms |
| PR interval | 142 ms |
| QRS duration | 144 ms |
| QT / QTc | 378 / 490 ms |
| P/QRS/T axis | 76 / 145 / 47° |
| RV5 / SV1 | 0.482 / 0.050 mV |
1. Rate and Rhythm
- Rate: ~101 bpm - sinus tachycardia
- Rhythm appears regularly irregular (possibly sinus tachycardia with occasional ectopic beats - the tracing shows beats that vary slightly in morphology across the leads, consistent with possible ventricular ectopy)
2. P Waves
- P waves are present and precede QRS complexes
- P axis ~76° - normal sinus origin
- PR interval: 142 ms - normal (within 120-200 ms)
3. QRS Complex
- QRS duration: 144 ms - this is broad (normal < 120 ms; >120 ms = bundle branch block territory)
- QRS axis: 145° - this is in the range of right axis deviation (normal is -30° to +90°; >+110° = RAD)
- The broad QRS with right axis deviation raises concern for right bundle branch block (RBBB) or another intraventricular conduction defect
4. Repolarisation
- QTc: 490 ms - this is prolonged (normal < 440 ms in males, < 460 ms in females). A QTc of 490 ms is significantly prolonged and warrants attention
- T axis: 47° - relatively normal T axis
5. Voltage
- RV5 (0.482 mV) and SV1 (0.050 mV) are both low - the sum is well below the Sokolow-Lyon criterion for LVH (>3.5 mV), so no LVH by voltage
Key Findings Summary
| Finding | Significance |
|---|---|
| HR 101 bpm | Sinus tachycardia |
| QRS 144 ms | Wide QRS - bundle branch block or intraventricular conduction delay |
| QRS axis +145° | Right axis deviation |
| QTc 490 ms | Prolonged QT - risk of torsades de pointes |
| PR 142 ms | Normal |
Clinical Impression
- Sinus tachycardia at 101 bpm
- Wide QRS complex (144 ms) with right axis deviation - the combination is consistent with Right Bundle Branch Block (RBBB), though the axis would be more typical of a bifascicular block (RBBB + left posterior fascicular block). A physician should confirm with clinical correlation.
- Prolonged QTc of 490 ms - this is a clinically significant finding. Causes include:
- Electrolyte disturbances (hypokalemia, hypomagnesemia, hypocalcemia)
- Medications (antiarrhythmics, antibiotics like azithromycin, antipsychotics, antimalarials)
- Congenital long QT syndrome
- Ischemic or structural heart disease
- QTc prolongation with an underlying bundle branch block should be interpreted cautiously - the QTc measurement by the machine may overestimate true QTc in the setting of a wide QRS
Important note: This ECG interpretation is for educational support only and should be confirmed by a qualified clinician. Given the prolonged QTc and wide QRS, this patient needs a clinical review, medication reconciliation, and electrolyte check if not already done.
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