EKG of the Week
/
+ EKG Interpretation
Dr. Ohlbaum's Explanation
Looking at this EKG in an organized way, there are P waves, there is a P before every QRS and a QRS following every P, the P wave looks normal but the rate is 55 so it is sinus bradycardia. The PR is normal.
The QRS is normal size and duration, the axis is normal, there are no significant Q’s. (In order to be significant a Q has to be one little box deep, one little box wide and ¼ the height of the R so the tiny things in the inferior leads are not significant).
Now let’s look at the ST and T. there are inverted T waves in V1 thru V4. The computer read this as anterior ischemia. What do you think? Now is time to ask about the story.
This is a 22 year old asymptomatic woman.
Does that change anything?
In general, in about 50% of women, the T is inverted in V1. Inverted T in V2 is less common but still about 10% in young women and inverted T is seen “occasionally” in V3 and “rarely” in V4. When T is inverted in 2 or more of right precordial leads in a normal adult it is called a “persistent juvenile T wave”.
So, this is not ischemia in a young, healthy, assx, woman: sinus bradycardia, and persistent juvenile T wave pattern that is not abnormal.
