ECG Interpretation

Machine-Reported Parameters (from header)

Step-by-Step Analysis

• Rate 78 bpm - normal sinus rate
• Regular rhythm with visible P waves preceding each QRS - Normal sinus rhythm

• Normal (normal range: 120-200 ms)
• No heart block

• Normal (< 120 ms)
• No bundle branch block, despite the form asking about "STEMI/New LBBB" - the QRS is narrow, ruling out a complete BBB

• QTc of 440 ms is at the upper limit of normal (borderline prolonged for males; normal upper limit is 440 ms in men, 460 ms in women)
• Worth monitoring, especially if the patient is on QT-prolonging drugs

• P axis ~74 degrees - normal
• QRS axis ~70 degrees - normal axis
• T axis ~96 degrees - slightly wider than QRS axis, suggesting mild T-wave axis deviation (T-axis 96 vs QRS 70 = ~26 degrees separation, mild)

• aVR: predominantly negative QRS (expected)
• Morphology appears consistent with normal conduction

• V1-V2: Deep S waves visible - expected in right precordial leads; no broad notched R wave to suggest RBBB
• V3-V4: Transitional zone appears around V3-V4 (normal)
• V5-V6: Positive QRS complexes with upright T waves
• No obvious ST elevation or depression detected across the visible tracings
• T waves appear generally concordant with QRS direction

• The form has "STEMI/New LBBB: YES/NO" and "Life-threatening arrhythmia: YES/NO" left blank, indicating these were not definitively identified at the time of acquisition
• The tracing is marked "Unconfirmed" (top right) - the machine interpretation has not been verified by a clinician

Summary Interpretation

Normal sinus rhythm, rate 78 bpm. Normal PR interval and QRS duration. Borderline QTc prolongation at 440 ms. Normal QRS axis. No acute ST changes, no bundle branch block, no obvious ischemic pattern identified on this tracing.

Clinical Recommendations

1. Compare with prior ECGs - essential to identify any new changes, particularly for the borderline QTc
2. Review medications - QTc 440 ms warrants checking for QT-prolonging drugs (antiarrhythmics, some antibiotics, antipsychotics)
3. Clinical correlation - the structured form (NUH05564S) flags for STEMI/LBBB and life-threatening arrhythmia screening; based on this tracing, neither criterion appears met, but the treating clinician must confirm
4. If symptoms of chest pain/syncope/palpitations are present, further evaluation (troponin, continuous monitoring, echo) is warranted regardless of a "normal" ECG

Disclaimer: This is an AI-assisted interpretation for educational/clinical decision support purposes only. All ECGs must be formally reviewed and signed off by a qualified clinician. The "Unconfirmed" watermark on this tracing indicates it has not yet received clinician sign-off.