A 51 year old female presents to ED complaining of shortness of breath and chest pain. Below is the patients ECG:
Describe and Interpret the ECG
Answer
Rate: 96 beats per minute
Rhythm: normal sinus rhythm
Axis: Normal Axis
Intervals
- PR: 160ms
- QRS: 110ms
- QTc: 455ms (Bazett)
Additional:
Tall deep complexes, specifically
- very tall R wave in I (off the grid)
- R wave >11mm in aVL
- Tall R waves V4-V6
- Very deep S waves III, V1-V2
- S wave V2 + R wave V6 > 35mm
Biphasic T waves and ST depression in the lateral leads
Concave ST elevation in aVR
The above ECG shows both voltage and non voltage criteria for LVH with strain pattern.
The patient had a history of Hypertrophic Cardiomyopathy and was clinically in CCF.