ECG Strip: Strange QRS Complexes

[18G]

I acquired this 12-lead and wasn't so sure about the QRS complexes in some of the leads specifically leads III, avf, and V1. I have never seen QRS morphology like this. Does anyone have any idea what causes this?

Patient History:
34 y/o male, no cardiac or resp history. Does have hx of pre-diabetes only. Average physical condition. Is currently experiencing high levels of anxiety and stress and has been over past month due to a circumstantial family situation. Also, occasional smoker (pack a week sporadically) and consumer of moderate, daily caffeine (soda).

Does anyone have any idea what causes QRS complexes to appear like this?

LINK TO 12-LEAD

 

[katgrl2003]

Fascicular block?

 

[18G]

Paging TomB.. Paging TomB...

 

[abckidsmom]

Paging TomB.. Paging TomB...

Edit the title to have his name in it.

Early repolarization? I really don't know, that's just a guess.

 

[Shishkabob]

Physiological left axis deviation.



And that's all I'm going to say about that EKG

 

[medicsb]

Probably a nonspecific intraventricular conduction defect

 

[Medic87]

I acquired this 12-lead and wasn't so sure about the QRS complexes in some of the leads specifically leads III, avf, and V1. I have never seen QRS morphology like this. Does anyone have any idea what causes this?

Patient History:
34 y/o male, no cardiac or resp history. Does have hx of pre-diabetes only. Average physical condition. Is currently experiencing high levels of anxiety and stress and has been over past month due to a circumstantial family situation. Also, occasional smoker (pack a week sporadically) and consumer of moderate, daily caffeine (soda).

Does anyone have any idea what causes QRS complexes to appear like this?

LINK TO 12-LEAD

Did you even look at the numbers on top of the page ?????Left axis deviation is -30to -90 the number on top shows -15 ! Before you jump and say that this is a left fasicular block,review your :censored::censored::censored::censored:tt!!!!

 

[abckidsmom]

Did you even look at the numbers on top of the page ?????Left axis deviation is -30to -90 the number on top shows -15 ! Before you jump and say that this is a left fasicular block,review your :censored::censored::censored::censored:tt!!!!

Before you use a censored word in a thread, review your ANSWER THE QUESTION, don't just tell us how smart you are.

 

[Shishkabob]

Did you even look at the numbers on top of the page ?????Left axis deviation is -30to -90 the number on top shows -15 ! Before you jump and say that this is a left fasicular block,review your :censored::censored::censored::censored:tt!!!!

So... how about being constructive and stating what it is instead of attacking someone?

 

[EMSrush]

Did you even look at the numbers on top of the page ?????Left axis deviation is -30to -90 the number on top shows -15 ! Before you jump and say that this is a left fasicular block,review your :censored::censored::censored::censored:tt!!!!

Linuss wrote PHYSIOLOGICAL LAD, not PATHOLOGICAL, and he was correct.

 

[Sam Adams]

undiagnosed atrial septal defect? (crochetage (sp?) sign?)

 

[MSDeltaFlt]

Definite left physiologic left axis. From what I can see on my phone (unable to zoom), looks like V1 has a positive R wave with an overall small complex. So I'll call that a RBBB with low voltage.

 

[TomB]

I think what you see is fragmentation of the QRS complex. It may indicate higher risk of future adverse events in patients with known coronary artery disease. I only recently learned about this (from Dr. John M.).

http://www.theheart.org/article/822713.do

Tom

 

[TheGodfather]

almost looks like osborn waves to me! (im sure that im wrong, but just a thought! electrolyte/mineral deficiency?)

 

[Fish]

That looks like it could be Benign Early Repolerization of the Ventricle