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Finding Sources
Finding Sources
Finding Sources
Finding Sources
Now I have enough from the ECG image itself and the textbook context. Let me provide a comprehensive interpretation.
ECG Interpretation — Patient: Moz Meena | Date: 17-05-2026 | Time: 09:35 PM
Machine Report Summary
| Parameter | Value |
|---|---|
| Ventricular Rate | 124 BPM |
| PR Interval | 138 ms |
| QRS / QT / QTc | 101 ms / 316 ms / 457 ms |
| P/QRS/T Axis | 22° / 38° / 115° |
| RV1/SV5 Amp | 0.00 / 0.25 mV |
| RV5/SV1 Amp | 1.58 / 1.52 mV |
Machine diagnoses: Sinus Tachycardia · Sinus Arrhythmia · Frequent PAC · T Abnormality → Abnormal ECG
Lead-by-Lead Findings
Rhythm
- Sinus tachycardia at ~124 bpm — P waves are present before each QRS, PR interval is 138 ms (normal: 120–200 ms), confirming a sinus origin.
- Sinus arrhythmia — slight beat-to-beat variation in the RR interval, a common normal variant but noted here.
- Frequent PACs (Premature Atrial Contractions) — early-occurring narrow QRS complexes with abnormal or absent P-wave morphology are visible, particularly prominent in leads I, II, V1. These are ectopic atrial beats arising before the next expected sinus beat.
Intervals
- QRS 101 ms — borderline (upper limit of normal is ~100 ms); suggests minimal conduction delay, possibly incomplete RBBB.
- QTc 457 ms — mildly prolonged (normal: ≤440 ms in males, ≤460 ms in females). This warrants attention, especially if the patient is on QT-prolonging medications.
ST Segment
The ST level table shows mostly flat or slightly negative values:
- Leads I, II, III, aVF: −0.01 to −0.03 mV (minimal ST depression, within normal limits)
- aVR: +0.03 mV (normal reciprocal change)
- V1: +0.05 mV, V2: +0.04 mV (early precordial slight elevation, non-specific)
- V5: −0.04 mV (borderline)
No significant ST elevation or depression suggesting acute ischemia.
T-Wave Abnormality
The machine flags T abnormality — likely referring to the T-wave axis of 115°, which is discordant from the QRS axis (38°). This wide QRS–T angle can indicate:
- Non-specific T-wave changes
- Early repolarization abnormality
- Possible right ventricular strain pattern
Axes
- P axis: 22° ✓ (normal)
- QRS axis: 38° ✓ (normal, no axis deviation)
- T axis: 115° — abnormally rightward relative to QRS, explaining the T abnormality flag
Summary of Findings
| Finding | Clinical Significance |
|---|---|
| Sinus tachycardia (124 bpm) | Needs cause: fever, pain, anxiety, hypovolemia, thyrotoxicosis, anemia, PE |
| Frequent PACs | Can be benign (caffeine, stress) or sign of atrial irritability; frequent PACs can trigger AF |
| QTc 457 ms (mildly prolonged) | Check medications (antihistamines, antibiotics, antiarrhythmics); electrolytes (K⁺, Mg²⁺, Ca²⁺) |
| T-wave abnormality | Non-specific; requires clinical correlation; rule out ischemia if symptomatic |
| No acute ST changes | No evidence of STEMI on this tracing |
Clinical Recommendations
- Investigate the cause of tachycardia — fever, dehydration, anemia, thyroid disease, pain, or anxiety are common.
- Review current medications for QT-prolonging agents (e.g., azithromycin, antihistamines, metoclopramide).
- Check electrolytes — potassium, magnesium, and calcium all affect QTc.
- If PACs are symptomatic (palpitations), a 24-hour Holter monitor is indicated to quantify PAC burden and exclude brief AF runs.
- Physician review mandatory — the machine explicitly states "Unconfirmed Report, Need to Review"; this ECG requires clinical correlation before any management decision.
⚠️ Disclaimer: This is an educational interpretation only. Clinical decisions must be made by a qualified physician who has examined the patient.
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