LAD
PVCS
MFA Tachycardia
Old inferior MI

I can't determin whether it's a sinus rhythem , cause i can't see a constant p wave nor constant R-R intervals

heart rate approximately : 150 p/m

I think there's left deviation in the cardiac axis

there's deep S wave in V5
QRS comlexes are of normal duration

i suggest SVT

فعلا مشاركات رائعة
أنا ضعيف عموما بأمور ال ecg
وإن شاء الله سأستفيد جديا من هذه المشاركات
سأفكر قليلا قبل أن أجيب

No STUDENTS to reply???????????????? This is a final examination case

Thanx for those who replied and wanted to know more

This is a simple case that you always face either in the exams or in your practice

There is no P waves to start with so this is not sinus rhythm, instead there is fibrillatory waves which suggests atrial fibrillation, this is confirmed by the obvious irregularity of the ventricular response.

There is no PR interval to comment on

the QRS complex shape and duration is normal, but there is abnormal Q waves in the Inferior leads, somebody will comment bt there is small R in lead II, Yes.......but this is called initial r which suggests loss of forces due to old inferior MI

There is mild ST depression in the lateral leads

There is isolated T wave inversion in aVL

There is rapid ventricular response about 150 bpm

There is left axis deviation

The final diagnosis is Atrial Fibrillation with rapid ventricular response and old inferior MI

مشكور أستاذ رائد على هذه الحالة التي استفدنا منها بشكل كبير وننتظر مزيد منك