EKG of the Week

EKG of the week 4_Page_2.jpg

This is a 73 year old man with a hx of CAD and a stent 2 months earlier who presented to clinic with 2 months of watery diarrhea.

+ EKG Interpretation

Dr. Ohlbaum's Explanation

There are P waves and QRS’s, there is a P before every QRS and a QRS after every P. The rate is slow. The rhythm is mostly regular but the 4th beat is early and that P is a little different so that beat is a PAC. So, the rhythm is sinus bradycardia with a premature atrial contraction. The QRS looks normal except for a slightly negative QRS axis.

Now look at the ST and T. The ST is “saggy” but not >1mm down in several leads. The T waves are inverted in the anterior leads but it is not deep or symmetric.

I want you to look at where the end of the T wave appears to be in V1,2,3. Draw a line from that point down on the rhythm strip. (Remember that all the leads are recorded simultaneously). When you look at lead II and V5 there is an extra wave after the time of that T wave. What do you think this might be?

That is a U wave.

This man had a K of 1.9 related to the months of diarrhea.

Further Reading:

Follow up EKGs:

Full EKG Index