Interesting ECGs

Once a month at this site there will appear a new 12-lead electrocardiogram (ECG). Accompanying the ECG will be a clinical vignette relevant to the tracing and one or two questions for you to answer. The tracings will be classified by their interpretive difficulty:


Basic: The ECG represents a basic clinical problem or basic ECG principle. Should be mastered by a graduating medical student.


Intermediate: The ECG presents a more challenging or complex problem. Should be able to be mastered by most graduating Family Practice, Medicine or Emergency Medicine residents.


Advanced: Presents a complex, subtle or advanced ECG concept. Physicians with a special interest in ECG’s or Cardiology fellows should find these tracings interesting.


The Answers and Follow up will be posted after everyone is given 2 weeks to check out and discuss what is posted!

69 year old man            

with substernal chest discomfort.

BP 70 mm Hg. History of HTN.

Vent. rate 64 bpm
QSR duration 80 ms
PR interval 138 ms
QT/QTc 394/406 ms
P-R-T axes 59 55 84


Questions for Thoughts


  1. In what part of the heart is there a problem?
  2. What is the differential for the ST-segment abnormalilty seen in V1 and V2?


John McPherson MD

BCFR Medical Director

Timothy J. Mills Fire Rescue Center

1040 South Florida Ave.

Rockledge, FL 32955


Answering Service 24/7

(321) 952-3186


(321) 633-2056


(321) 288-0865


(321) 723-7866




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