ECG Case 073

ECG of a 7 year old boy presenting with intermittent feeling of ‘butterflies fluttering’ in his chest

ECG Case 073 Top 100

Describe and interpret this ECG

ECG ANSWER and INTERPRETATION

Rate:

  • 95-100

Rhythm:

  • Sinus Rhythm
  • Regular

Axis:

  • Normal (80 deg)

Intervals:

  • PR – Short (~80-100ms)
  • QRS – Prolonged (100-120ms)
  • QT – 320ms (QTc Bazett ~ 400 ms)

Segments:

  • Normal

Additional:

  • T Inversion V1, aVR
  • Biphasic T wave V2
  • RSR’ Pattern V1
  • ? Slurring QRS – II,III, V4

Interpretation:

  • T wave changes
  • Prominent R waves V5-6 (less than age adjusted upper limit)
  • RSR’ Pattern V1
  • Short pr interval
  • QRS Prolongation – QRS duration > 80ms in children <8yrs is abnormal
  • S wave aVL – ? pseudo-infarction pattern
  • Possible slurring QRS Upstroke

CLINICAL PEARLS

Features suggestive of Wolff-Parkinson-White syndrome

  • T wave and prominent R waves consistent with age
  • I don’t have any further clinical information of this case as to the final diagnosis

Paediatric ECGs are challenging with normal intervals and morphology differing from both adult ECGs and by patient age. If in doubt as to the presence of pathology review of the ECG by a paediatric cardiologist is desirable



TOP 150 ECG SERIES



Emergency Medicine Specialist MBChB FRCEM FACEM. Medical Education, Cardiology and Web Based Resources | @jjlarkin78 | LinkedIn |

One comment

  1. I wonder about Lown-Ganong-Levine in this case . As short pr interval without delta wave

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