2-year old boy presenting with febrile seizure. Interpret the ECG.
Describe and interpret this ECG
ECG ANSWER and INTERPRETATION
This is a normal paediatric ECG, displaying multiple age-appropriate features:
- Heart rate of 110 bpm (normal for age).
- Dominant R waves in V1-3.
- Partial RBBB (RSR’ pattern in V1).
- Juvenile T-wave pattern (T wave inversion in V1-3).
Any of the following findings may be normal on the paediatric ECG:
Heart rate and rhythm
- Heart rate >100 beats/min.
- Marked sinus arrhythmia.
- Rightward QRS axis > +90°
- Dominant R wave in V1
- RSR’ pattern in V1
- T wave inversions in V1-3 (“juvenile T-wave pattern”)
- Slightly peaked P waves (< 3mm in height is normal if ≤ 6 months)
- Short PR interval (< 120ms) and QRS duration (<80ms)
- Slightly long QTc (≤ 490ms in infants ≤ 6 months)
- Q waves in the inferior and left precordial leads.