Wednesday, 10 May 2017

ECG of the Week - 8th May 2017 - Interpretation

The following ECG is from a 12 yr old who presented to the Emergency Department following an episode of dysponea and palpitations.


 
Click to enlarge

Rate:
 
  • 72 bpm
Rhythm:
 

  • Sinus rhythm
    • Note baseline irregularity due to printing issue
Axis:
  • Normal
Intervals:
 
Complexes #1-9, #12
  • PR - Normal
  • QRS - Normal
Complexes #10-11
  • PR - Short
  • QRS - Prolonged

Additional:
  • Distinct QRS morphology complexes #10-11
    • Delta wave
    • Abnormal ST / T wave likely secondary to pre-excitation

Interpretation:
  • Intermittent pre-excitation / WPW
    • Only seen in complexes #10-11

What happened ?
 
The patient was referred to paediatric cardiologists for further follow-up and investigation.
 
References / Further Reading
 
Life in the Fast Lane
Textbook
 
  • Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.