EKG of the Week
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+ EKG Interpretation
Dr. Ohlbaum's Explanation
First, let me tell you about the patient. This is a HEALTHY 23 yr old woman (EKG routine for a data base).
There is a P before every QRS and a QRS after every P, nothing extra, nothing missing. The rate is slow and there is a gradual increase and decrease in PP and RR intervals. It is sinus brady (slow, rate SO), with sinus arrhythmia (varies with breathing). That is normal and usually more noticeable in young people and easier to see at slow rates.
Her PR is normal. The QRS is normal. What do you think about the T wave? The computer read it as anterior ischemia because of the inverted T waves in Vl,2,3. But is it ischemia? Is it abnormal?
The answer is that inverted T waves in the right precordial leads can be normal. Inverted T-waves in Vl happens in about 50% of women, perhaps even more in young women. Inverted T's about 10% in V2, "occasionally" in V3 and "rarely" even in V4 in healthy young women.
This normal pattern in young women is referred to as a persistent juvenile T wave.
Final reading: sinus bradycardia with sinus arrhythmia, persistent juvenile T wave, otherwise normal.
