Can anyone interpret this ?

[Tellingfibs]

Is there anyone out there who can give a rough interpretation of this ? It’s not mine, but a friend just had this result from a GP’s ecg and is worried. I think I can see breaks in the line just where it becomes inverted ( all four lines have it ) and it might as well be hieroglyphics to me !

Annie

[mjames1]

No one here is really qualified to interpret an EKG. That said it looks like it's showing ST segment depression which could mean something, or it could mean nothing. But it should be followed up ideally by an electrophysiologist, or at least a cardiologist. GP's are usually not very good at EKG analysis and often just go by the machine's AI interpretation, which in this case is "abnormal". A good electrophysiologist ignores the machines interpretation because they are wrong much of the time.

Jim

[Tellingfibs in reply to mjames1]

Thank you Jim. I’m sure someone will call my friend and suggest he is seen. The doc took the ecg because his blood pressure was ‘up and down’. I gave told him to ring the surgery .

Annie

[Buffafly]

I’m wondering why your friend has the printout! All I can say is that there are recordings from 12 leads (hence the ‘breaks’) and a rhythm strip. What is the next step for your friend?

[Tellingfibs in reply to Buffafly]

I have told him if there was a concern, surely the surgery will ring him, but that he could chivvy them up by ringing.

Annie

[Cliff_G]

Looks ok to me, as a rank amateur. But it needs a proper interpretation by a cardio or EP. The rhythm strip is regular which suggests to me that whatever the reason is for an ECG to be taken, if that's an arrhythmia, it probably hasn't showed up here, which would be typical, and needs a Holter.

The "abnormal" text needs to be taken with a pinch of salt, these machines aren't great at getting rhythm oddities right. Wait for a consultant's review.

[Tellingfibs in reply to Cliff_G]

Thanks for responding.

[MaryCa]

Looks good to my non trained eyes

[Tellingfibs in reply to MaryCa]

Thank you 👍

[Ppiman]

Can I ask what your friend's symptoms were and why he had this ECG taken?

What I think I can see is a "wide QRS", which shows as broadened peaks of the ventricular contraction. This is often caused by a "bundle block" with the widening being caused by a slight delay between the left and right ventricles beating (there are, in a way, "two peaks" overlaid on top of each other). This is a common finding and often of no consequence.

I have a left bundle branch block ("LBBB"). The problem with these is not so much in themselves but that they cause the ECG to be hard to interpret and always fool the AI used to analyse the ECG, giving rise to the AI calling it "abnormal". Also, the apparent depressed ST segments are also almost certainly an artefact caused by the bundle block, rather than being indicative of anything serious (since your friend would likely already know if he had had a serious cardiac event).

The "upside down" QRS segments are called "missed beats" on my home ECG device (a Contec PM20). I attach a strip to show you. These are, I think, atrial ectopic beats and, again, almost always of no consequence.

Looking at the strip and my own, I would guess your friend was feeling palpitations in his chest, and perhaps some anxiety from this.

Steve

ECG strip showing "wide QRS" from LBBB and "missed" atrial ectopic beats.

[Tellingfibs in reply to Ppiman]

Thanks for such a comprehensive description Steve. My friend says he was given the ecg because his blood pressure was ‘up and down’. He reports no heart symptoms and is 82. When he used my Kardia last year, the result was what everyone on this forum would wish for ! Surely the GP would have suspected some heart itregularity to offer an ecg 🤔

Annie

[Ppiman in reply to Tellingfibs]

I suspect that at 82 it's likely the GP noticed some ectopic beats while taking his blood pressure and thought an ECG would be worthwhile.

Steve

[Tellingfibs in reply to Ppiman]

Ah yes, a GP being thorough. Nothing dramatic, hopefully. Thanks Steve.

Thirza

[Marymara]

Show it to a doctor, a little knowledge is dangerous.

[Bingofox007]

I’m certainly no expert but there’s no P wave. Is your friend known to have AF? Defo GP review. Take care 🦊x

[Tellingfibs in reply to Bingofox007]

Thanks Bingofox. He has never noticed any sign of arrhythmia but of course that doesn’t mean he doesn’t have one. I used my Kardia on him a while back and the reading was perfect, but still, paroxysmal is often difficult to capture. I have suggested he nags the GP surgery if they don’t get back to him !