ECG Case 074
97 year old gentleman found unconscious at home. Brought into emergency by ambulance at 10am having last been seen at 8pm the evening before.
Describe and interpret this ECG
ECG ANSWER and INTERPRETATION
Rate:
- 30
Rhythm:
- Irregular
- No p waves visible
Axis:
- Normal (+20 deg)
Intervals:
- PR – no p waves visible
- QRS – prolonged (160ms)
- QT – 720-760ms (QTc Bazett 570-600 ms)
Segments:
- Inferior ST sagging
Additional:
- Right bundle branch block
- Terminal QRS Notching – J wave
Interpretation:
- Bradycardia
- Slow atrial fibrillation
- J waves
- QT Prolongation
CLINICAL PEARLS
ECG Findings consistent with hypothermia
Patient’s core temperature was 28°C (82°F)
FURTHER READING
- ECG Library – Hypothermia
- ECG Library – Osborn Wave (J Wave)
- CCC – Hypothermia
- Eponymictionary – John J Osborn (1917 – 2014)
TOP 150 ECG SERIES
Emergency Medicine Specialist MBChB FRCEM FACEM. Medical Education, Cardiology and Web Based Resources | @jjlarkin78 | LinkedIn |