ID 352 –Sinus rhythm With premature atrial complex

1. Stepwise interpretation of ECG
ID 352 –Sinus rhythm
With premature atrial complexes

2. ID 352 – 62 year old man with palpitation

3. Can you see P waves?
ID 352 – 62 year old man with palpitation

4. Yes – There is sinus rhythm with premature atrial complexes (the P waves marked by an arrow)
Every 3
rd
P is premature (trigeminy) - The sinus P waves show no evidence of right or left atrial
enlargement
ID 352 – 62 year old man with palpitation

5. Let’s now look at the QRS complexes: There is normal QRS axis (between 0 and 90 degrees)
ID 352 – 62 year old man with palpitation

6. The QRS duration is normal: There is no right bundle branch block, left bundle branch block or non-specific block
ID 352 – 62 year old man with palpitation

7. There is no right ventricular hypertrophy or left ventricular hypertrophy
ID 352 – 62 year old man with palpitation

8. There are no QRS signs of myocardial infarction –There are normal ST segment and normal T waves
ID 352 – 62 year old man with palpitation

9. ID
ID 352 – Final diagnosis: Sinus rhythm, 83 bpm, with atrial premature complexes
in a pattern of trigeminy. Otherwise, a normal ECG.