Explain me ecg changes in images with pdf

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ECG Analysis — Goutam Giloi (05/06/26, Midnapore Hospital)

Visual Observations from Your Tracing

Looking at the submitted 12-lead ECG (10 mm/mV, 25 mm/s):

Feature	Observation
Rhythm	Regular narrow QRS complexes; P waves precede each QRS → likely sinus rhythm
Rate	Estimated ~70-90 bpm (R-R interval ~3-4 large boxes)
QRS width	Narrow (<120 ms) - no bundle branch block pattern visible
Precordial voltages	Tall R waves in left precordial leads - possible LVH by voltage criteria
ST segment	No gross ST elevation across leads; requires careful measurement
T waves	Upright in most visible leads; possible flattening in some inferior leads
Q waves	No obvious pathological Q waves on gross inspection
P waves	Present before each QRS; morphology needs closer measurement

Key ECG Changes You Should Know

ST Elevation - > 1 mm in ≥2 contiguous limb leads (or >2 mm precordial) = STEMI until proven otherwise. Mimics include pericarditis (diffuse, saddle-shaped), LVH strain, Brugada, early repolarisation, PE.

ST Depression - Subendocardial ischemia, NSTEMI, digoxin effect, LVH strain pattern in lateral leads.

Pathological Q waves - ≥0.03 s wide AND ≥0.1 mV deep in ≥2 contiguous leads = old transmural infarction. In V2-V3, even ≥0.02 s qualifies. (Washington Manual, 2023)

LVH Criteria (relevant if tall voltages confirmed):

Sokolov-Lyon: SV1 + RV5/RV6 > 35 mm
Cornell (men): RaVL + SV3 > 28 mm
Strain pattern: ST depression + T-wave inversion in I, aVL, V5-V6 (Harrison's, 22nd ed, 2025)

MI Localisation by leads:

Inferior: II, III, aVF → RCA
Anterior: V1-V4 → LAD
Lateral: I, aVL, V5-V6 → LCx
Posterior: Reciprocal changes in V1-V3

Download your full PDF report (with patient ECG image, all tables, references, and differential diagnosis):

ECG Changes Analysis

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Important: This analysis is educational. A qualified cardiologist must perform the formal clinical ECG interpretation, especially before any treatment decision.

Ecg changes analysis report pdf

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ECG Changes Analysis

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The report (3.2 MB) includes:

Your patient's ECG image (Goutam Giloi, 05/06/26, Midnapore Hospital)
Visual analysis of the submitted tracing - rhythm, QRS, ST segment, T waves, voltage
ECG basics table - normal durations and amplitudes for all components
Common pathological ECG changes - ST elevation, ST depression, T-wave inversion, Q waves, LBBB, RBBB, delta waves, prolonged QTc
LVH voltage criteria - Sokolov-Lyon, Cornell, strain pattern
MI ECG evolution - hyperacute through chronic phases
MI localisation table - which leads correspond to which artery
Differential diagnosis of ST elevation - STEMI vs mimics
Pathological Q wave criteria
Sgarbossa criteria for STEMI in LBBB/paced rhythm
References - Braunwald's, Harrison's, Washington Manual, Rosen's EM

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