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Home | Top 100 | TOP 100 ECG | ECG Case 074

ECG Case 074

by Dr John Larkin, last update April 28, 2019

97 year old gentleman found unconscious at home. Brought into emergency by ambulance at 10am having last been seen at 8pm the evening before.

ECG Case 074 Top 100

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



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About Dr John Larkin

Dr John Larkin: Emergency Medicine Specialist MBChB FRCEM FACEM. Medical Education, Cardiology and Web Based Resources | Twitter | LinkedIn

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