Stepwise interpretation of ECG

ID 175

ID 175 – 58 year old man followed in the Cardiac Clinic because of coronary artery disease

ID 175 – 58 year old man followed in the Cardiac Clinic because of coronary artery disease

Can you see P waves?

ID 175 – Normal sinus rhythm, 88/min.

Yes. There is sinus rhythm, 88/min. Each P is followed by a QRS complex, with a constant P-Rinterval (140 msec)

ID 175 – Normal sinus rhythm, 88/min.

There are no signs of right or left atrial enlargement

ID 175 Normal Sinus rhythm, 88/min. Left bundle branch block

The QRS duration is prolonged (145 msec.), with a pattern of Left Bundle Branch Block (LBBB)

ID 165 Normal Sinus rhythm, 88/min. Left bundle branch block

The presence of LBBB may mask the diagnosis of left ventricular hypertrophy and/or myocardial infarction

ID 165 Normal Sinus rhythm, 88/min. Left bundle branch block

In left bundle branch block the abnormal depolarization is usually associated with secondary abnormal repolarization (ST depression and negative T in the leads showing a broad R wave)

ID 165 Final diagnosis: Normal Sinus rhythm, 88/min. Left bundle branch block

ID 165 Final diagnosis: Normal Sinus rhythm, 88/min. Left bundle branch block