Answer Case 2: Difference between revisions

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***'''This is a regular rhythm and every QRS complex is preceded by a p wave. The p wave is positive in II,III, and AVF and thus originates from the sinus node. Conclusion: sinus rhythm.'''
***'''This is a regular rhythm and every QRS complex is preceded by a p wave. The p wave is positive in II,III, and AVF and thus originates from the sinus node. Conclusion: sinus rhythm.'''
**Hartfrequency  
**Hartfrequency  
***'''Use the 'count the squares' method (a bit less than 3 large squares ~> 300-150-100), thus about 110 bpm.'''
***'''Use the 'count the squares' method (a bit less than 3 large squares ~> 300-150-100), thus about 110 bpm and thus sinustachycardia.'''
**Conduction (PQ,QRS,QT)  
**Conduction (PQ,QRS,QT)  
***'''PQ-interval=0.16sec (4 small squares), QRS duration=0.10sec, QT interval=320ms'''
***'''PQ-interval=0.10sec (2.5 small squares), QRS duration=0.10sec, QT interval=320ms'''
**Hartaxis
**Hartaxis
***'''Positive in I, II, III, and AVF. Thus a normal heart axis.'''
***'''Positive in I, II, negative in III and AVF. Thus a horizontal (normal) heart axis.'''
**P wave morphology
**P wave morphology
***'''The p wave is rather large in II, but does not fulfill the criteria for right atrial dilatation.'''
***'''The p wave is rather large in II, but does not fulfill the criteria for right atrial dilatation.'''
**QRS morphology
**QRS morphology
***'''No pathologic Q waves, RsR pattern in V3, but the QRS-duration < 0.12 seconds thus no bundle branch block is present. No left ventricular hypertrofy: S in V1 + R in V5 < 35mm.'''
***'''The QRS shows a slurred upstroke or delta wave.'''
**ST morphology
**ST morphology
***'''ST depressiion in II,III, and AVF and also in V5-V6. ST-elevation in AVL and V1.'''
***Negative T wave in I and AVF. Flat ST in V3-V5.'''
**Compare with the old ECG (not available, so skip this step)
**Compare with the old ECG (not available, so skip this step)
**Conclusion?
**Conclusion?


'''Acuut Anteroseptal Myocardial Infarction'''
'''[[Sinustachycardia]]] in a patient with a [[WPW|WPW pattern]]'''
{{clr}}
{{clr}}

Latest revision as of 15:15, 11 November 2008

This page is part of Cases and Examples

Previous ECG: Case 1 | Next ECG: Case 3

The ECG


Try to interprete this ECG using the 7+2 step method

Answer

  • Following the 7+2 steps:
    • Rhythm
      • This is a regular rhythm and every QRS complex is preceded by a p wave. The p wave is positive in II,III, and AVF and thus originates from the sinus node. Conclusion: sinus rhythm.
    • Hartfrequency
      • Use the 'count the squares' method (a bit less than 3 large squares ~> 300-150-100), thus about 110 bpm and thus sinustachycardia.
    • Conduction (PQ,QRS,QT)
      • PQ-interval=0.10sec (2.5 small squares), QRS duration=0.10sec, QT interval=320ms
    • Hartaxis
      • Positive in I, II, negative in III and AVF. Thus a horizontal (normal) heart axis.
    • P wave morphology
      • The p wave is rather large in II, but does not fulfill the criteria for right atrial dilatation.
    • QRS morphology
      • The QRS shows a slurred upstroke or delta wave.
    • ST morphology
      • Negative T wave in I and AVF. Flat ST in V3-V5.
    • Compare with the old ECG (not available, so skip this step)
    • Conclusion?

Sinustachycardia] in a patient with a WPW pattern

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