what the finding on this ECG

Reading File

Loading Image

Finding Sources

I have enough information to provide a comprehensive ECG interpretation. Let me now synthesize my analysis.

ECG Analysis

Machine-Reported Parameters (from printout)

Parameter	Value
HR	50 bpm
P-R interval	120 ms
QRS duration	92 ms
QT/QTc	454/416 ms
P/QRS/T axes	51° / 8° / 51°
RV5+SV1	4.04 / 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

Finding	Significance
Sinus bradycardia (50 bpm)	May be physiological (athletes, vagal tone, medications) or pathological (sick sinus, hypothyroidism, β-blocker use)
Left Anterior Fascicular Block	Causes mild LAD (−30° to −90°; here borderline/mild); isolated LAFB is generally benign but may indicate underlying structural disease
No acute ischemic changes	No STEMI/NSTEMI pattern
Normal QTc	No 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.

This is a shared conversation. Sign in to Orris to start your own chat.