ECG Analysis

• Female, age 35
• HR (ЧС): 128 bpm
• Date: 24-04-2026, 10:25
• Institution: Samarkand Branch, Republican Emergency Cardiac Centre, Angiography Department
• Settings: 25 mm/s, 10 mm/mV (standard)

Findings

1. 🔴 Sinus Tachycardia — HR ~128 bpm

• Regular rhythm with P waves preceding every QRS complex
• Rate of 128 bpm is consistent with sinus tachycardia (normal sinus P wave morphology visible in lead II)
• Clinical significance: In a 35-year-old woman referred to an angiography department, tachycardia may reflect sympathetic activation, pain/anxiety, hemodynamic compromise, anemia, fever, or underlying cardiac dysfunction

2. 🔴 Left Ventricular Hypertrophy (LVH) with Strain Pattern

• Tall R waves in lateral precordial leads (V4–V6)
• Deep S waves in right precordial leads (V1–V3)
• The Sokolow-Lyon index (SV1 + RV5 or RV6 > 35 mm) and Cornell criteria are likely met given the visible high QRS amplitude

• ST-segment depression with asymmetric T-wave inversion in lateral leads (I, aVL, V5, V6)
• This "strain" pattern reflects subendocardial ischemia from pressure overload (classically seen in hypertensive heart disease, aortic stenosis)

3. 🟡 ST-T Wave Changes

• Lateral leads (I, aVL, V4–V6): ST depression and T-wave changes consistent with the LVH strain pattern
• Anteroseptal leads (V1–V3): Deep S waves; T-wave morphology should be correlated with clinical context to exclude ischemia
• These changes are likely secondary to LVH but acute coronary syndrome (ACS) cannot be excluded in the clinical context of this patient (referred for angiography)

4. 🟡 Possible Left Axis Deviation or Normal Axis

• The QRS morphology in limb leads (I, II, III, aVL, aVF) suggests the axis is within normal limits or mildly leftward — consistent with LVH

5. Machine Parameters (from the left margin)

• ЧС (HR): 128 bpm
• P, QRS, T intervals are within printed reference ranges
• RV5, SV1 values are printed and elevated (consistent with LVH voltage)

Summary of Pathology

Clinical Correlation

1. Hypertensive heart disease with LVH + strain — the most common cause in this demographic
2. Hypertrophic cardiomyopathy (HCM) — must be excluded; HCM can show dramatic voltage increases and deep T inversions
3. Aortic stenosis — LVH + strain; would require echocardiogram correlation
4. The angiography referral suggests a workup for suspected coronary artery disease or chest pain — ST changes must be interpreted in the context of the clinical presentation

⚠️ Important: This ECG interpretation is based on visual analysis of the photograph. A formal interpretation requires the original tracing, full clinical history, prior ECGs for comparison, and correlation with symptoms, blood pressure, echocardiography, and laboratory values. The treating cardiologist's assessment takes precedence.