ECG Strip: Strange QRS Complexes

18G

18G

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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

scan0001gr.jpg
 
Last edited by a moderator:
Fascicular block?
 
Paging TomB.. Paging TomB... :)
 
Physiological left axis deviation.



And that's all I'm going to say about that EKG :P
 
18G said:
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

scan0001gr.jpg
Click to expand...


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!!!!
 
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Medic87 said:
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!!!!
Click to expand...

Before you use a censored word in a thread, review your ANSWER THE QUESTION, don't just tell us how smart you are.
 
Medic87 said:
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!!!!
Click to expand...

So... how about being constructive and stating what it is instead of attacking someone?
 
Medic87 said:
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!!!!
Click to expand...


Linuss wrote PHYSIOLOGICAL LAD, not PATHOLOGICAL, and he was correct.
 
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.
 
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
 
almost looks like osborn waves to me! (im sure that im wrong, but just a thought! electrolyte/mineral deficiency?)
 
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That looks like it could be Benign Early Repolerization of the Ventricle
 
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