Example 11

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  • Following the 7+2 steps:
    • Rhythm
      • The ECG shows a regular rhythm with normal P waves (positive in II, III and AVF, negative in AVR), all followed by QRS complexes. Sinusrhythm
    • Heart rate
      • About 100 bpm
    • Conduction (PQ,QRS,QT)
      • PQ: 160ms QRS: 80ms QT: 340ms QTc: 439ms
    • Heartaxis
      • QRS positive in I and AVF: normal heart axis
    • P wave morphology
      • Tall P waves in II, but no more than 2.5mm. Otherwise normal P wave morphology.
    • QRS morphology
      • Narrow QRS. No pathologic Q waves. Slow R wave progreesion. (However, lead V3 is probably at position V4R)
    • ST morphology
      • ST elevation in V2. Some ST elevation in leads I and AVL. Some ST depression in V6. Lead V3 again shows V4R which is not elevated.
    • Compare with the old ECG (not available, so skip this step)
    • Conclusion?

Sinustachycardia with anteroseptal infarction.