Stepwise interpretation of ECG

ID 168 – LVH

ID 168 78 year old woman with a heart murmur

ID 168 78 year old woman with a heart murmur

Can you see P waves?

ID 168 – Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block

Yes, there is sinus rhythm, 77/min. The P-P interval varies in keeping with sinus arrhythmia(a common normal finding) – Each P is followed by a QRS – The P-R is prolonged to 230 msec.(1st degree AV block)

ID 168 - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block

There are no signs of right or left atrial enlargement

ID 168 - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block

Let’s now look at the QRS complexes: There is normal QRS axis (between 0 and 90 degrees

The QRS duration is normal : There is no right bundle branch block, left bundle branch block or non specific block ‐

ID 168 - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block

ID 168 - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block – Left ventricular hypertrophy with repolarization abnormality

There are findings of left ventricular hypertrophy with ST-T abnormality (“strain pattern”)

ID 168 Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block Left ventricular hypertrophy with repolarization abnormality

There are no QRS changes of myocardial infarction

ID 168 Final diagnosis - Sinus rhythm, 77/min with sinus arrhythmia – First degree AV block Left ventricular hypertrophy with repolarization abnormality