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what the finding on this ECG

Reading File
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ECG Analysis

Machine-Reported Parameters (from printout)

ParameterValue
HR50 bpm
P-R interval120 ms
QRS duration92 ms
QT/QTc454/416 ms
P/QRS/T axes51° / 8° / 51°
RV5+SV14.04 / 1.44 mV
Machine conclusion: "602 Sinus Bradycardia; 207 Mild Left Axis Deviation — Abnormal ECG"

Visual Findings

1. Sinus Bradycardia (Rate ~50 bpm)
  • Regular rhythm with P waves before every QRS, normal P morphology, rate < 60 bpm
  • PR interval is normal (120 ms)
2. Left Axis Deviation (LAD)
  • QRS axis ~−8° (borderline/mild LAD)
  • Pattern consistent with Left Anterior Fascicular Block (LAFB / Left Anterior Hemiblock):
    • Small Q in I, aVL with tall R waves
    • Small R in II, III, aVF with deep S waves (rS pattern in inferior leads)
    • QRS duration is slightly widened but < 120 ms (not a full BBB)
3. No ST Elevation or Depression
  • No acute ischemic changes visible across the precordial leads (V1–V6)
  • No pathological Q waves
4. QTc = 416 ms — within normal range (< 440 ms in males)
5. Precordial leads (V1–V6)
  • Normal R-wave progression
  • No voltage criteria for LVH (RV5+SV1 = 5.48 mV — borderline, but axis and clinical context needed)

Summary of Findings

FindingSignificance
Sinus bradycardia (50 bpm)May be physiological (athletes, vagal tone, medications) or pathological (sick sinus, hypothyroidism, β-blocker use)
Left Anterior Fascicular BlockCauses mild LAD (−30° to −90°; here borderline/mild); isolated LAFB is generally benign but may indicate underlying structural disease
No acute ischemic changesNo STEMI/NSTEMI pattern
Normal QTcNo risk for torsades

Clinical Correlation Needed

  • Medications? β-blockers, calcium channel blockers, digoxin → can cause sinus bradycardia
  • Symptoms? Dizziness, syncope, fatigue → relevant if bradycardia is symptomatic
  • Age/history? LAFB in older patients may suggest hypertensive heart disease or ischemic cardiomyopathy
  • If bradycardia is symptomatic, 24-hour Holter monitoring and thyroid function tests are warranted
⚠️ This interpretation is for educational assistance only. All ECG findings must be confirmed by a qualified clinician in the appropriate clinical context — as also noted on the printout itself.
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