Ecg findings
Reading File
Here is a systematic analysis of this 12-lead ECG:
ECG Technical Details
- Speed: 25 mm/s | Gain: 10 mm/mV | Filter: 0.67–25 Hz AC50
Systematic Findings
Rate & Rhythm
- Rate: Approximately 84 bpm (regular R-R intervals)
- Rhythm: Normal sinus rhythm — P waves are present and precede every QRS complex
P Waves
- Upright in I, II, aVF — confirming sinus origin
- P morphology appears normal
PR Interval
- Appears within normal limits (~160–180 ms)
QRS Complex
- QRS duration: Appears narrow (< 120 ms) — no significant bundle branch block
- Axis: Normal (upright in I and aVF)
- Voltage: Low-normal in limb leads
ST Segment & T Waves
- ST depression is visible in leads V4–V6 and possibly II, aVF — raises concern for lateral/inferolateral ischemia or subendocardial injury
- T-wave changes: T waves appear flat or inverted in the lateral precordial leads (V4–V6)
- No obvious ST elevation in any lead
Q Waves
- No pathological Q waves clearly identified
Interpretation
Sinus rhythm at ~84 bpm with ST-T changes suggestive of:
Lateral/inferolateral ischemia or non-ST elevation acute coronary syndrome (NSTEMI/UA)
The ST depression and T-wave flattening in V4–V6 and inferior leads is the most clinically significant finding.
⚠️ Clinical Correlation Required
| Finding | Significance |
|---|---|
| ST depression V4–V6 | Lateral ischemia / demand ischemia |
| Flat/inverted T waves laterally | Ischemic T-wave changes |
| No ST elevation | No STEMI pattern |
Recommended next steps:
- Serial ECGs — compare with prior and repeat in 1–2 hours
- Troponin I/T (serial, 0h and 3h or 1h high-sensitivity)
- Clinical history — chest pain, dyspnea, risk factors
- Echocardiogram if hemodynamically unstable
- Consider cardiology consult if ACS is clinically suspected
⚕️ This analysis is for educational/supportive purposes. Clinical interpretation must be correlated with patient history, symptoms, and laboratory values by a qualified clinician.
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