EKG interpretations

EKG 1

Rate: 14 X 6 = 84 bpm
Rhythm: sinus
Axis: (up in I, up in II, up in aVF) normal axis
Waves:
P: up and morphologically normal (<2.5 mm tall, uniphasic, < 3 small boxes in duration) in lead II: all normal findings. downgoing in V1 (should be upright or biphasic with the late segment downgoing, but should not be negative in totality)
Q: no pathologic Q waves. there is a Q in lead III (normal variant)
R: normal
S: normal
T: inverted in V1 (normal finding); inverted and discordant in V2-V6 (abnormal), flat in I and aVL
U: none
Intervals:
PR: 5 small boxes (normal): therefore no primary AV block
QRS: 2 small boxes (normal): therefore no BBB;
QTc: ~ half the RR interval (grossly normal)
Segments:
ST: no elevation, no depression
Miscellaneous findings: none

Interpretation: T wave inversions/flattening suggesting of anteriolateral ischemia of uncertain acuity

EKG 2

Rate: 20 x 6 = 120
Rhythm: sinus
Axis: (up in I, up in II, up in aVF) normal axis
Waves:
P: up, uniphasic, and less than 2.5 mm tall in lead II: normal, up in V1: normal
Q: no pathologic q waves
R: normal
S: normal
T: upright and discordant in V1 (abnormal), otherwise upright throughout except aVR where downgoing T waves are normal
U: none
Intervals:
PR: 4 small boxes = normal
QRS: 2 small boxes = normal
QTc: grossly less than half the RR interval = normal
Segments:
ST: no elevations or depressions
Miscellaneous findings: none

Interpretation: Sinus tachycardia, upright T in V1, otherwise normal EKG

EKG 3

Rate: 8 x 6 = 54 bmp
Rhythm: sinus
Axis: up in I, up in II, up in aVF = normal axis
Waves:
P: difficult to see in lead II, downgoing in lead V1 (should be upright or biphasic with the initial portion upward)
Q: isolated q in III, which by itself is not pathologic. o/w no pathologic q waves
R: RR’ in V1 and V2
S: broad and deep S wave in the lateral leads (V6, I, aVL)
T: upright/discordant in V1-V3, appropriately downgoing in aVR, flat in III, otherwise upright
U: none
Intervals:
PR: 5 small boxes (upper end of normal)
QRS: 3.5 – 4 small boxes (abnormal) (edges most distinct in lead 1)
QTc: well under half the RR interval (normal)
Segments:
ST: no elevations or depressions
Miscellaneous findings:
1. RBBB: rR’ in V1-2, with QRS widening is suggestive of RBBB. the ‘deep/broad S waves in the lateral leads as well as T wave in versions in the anterior leads are classic findings in RBBB. Of note, in a simple RBBB, the axis will be normal as it is here.
2. there are regular deflections notable in the limb leads. These are probably due to a stimulator of some kind (gastric, spinal, bladder, etc)
Interpretation: Normal sinus rhythm with RBBB