EKG of the Week
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+ EKG Interpretation
Dr. Ohlbaum's Explanation
I put this one up to remind us all to always EVALUATE the patient. This is a healthy 30 yr old with no complaints.
There are P waves, with a P before every QRS and a QRS after every P wave. His overall rate is ~50 so borderline for NSR vs S brady- normal either way in a healthy active 30 yr old. The P's and their following QRS's are not perfectly regular, there is a slow shortening and then lengthening of the PP and RR interval. This is a normal rhythmic variation related to breathing, called sinus arrhythmia. You notice he only took one breath in 15 seconds so not surprising it is prominent. His P wave is normal. His PR is normal. His QRS duration and axis are normal. The QRS voltage is big but young people have big volts and you would not call LVH by volts alone in a young man. In addition, he is fairly slender so it is not surprising that precordial voltage large. He has ST elevation diffusely in inferior and anterolateral leads, it is a convex st elevation with a little "notch" at the end of the QRS {look at VS and V6). This is early repolarization and is also normal.
So ... this is a NORMAL EKG on a healthy 30 yr old. NSR (tho borderline), with sinus arrhythmia (normal), big volts (normal) and early repol (normal).
