You are reviewing a 73 year old patient who has presented after several days of chest pain. Their observations are within normal limits and their ECG is as follows:

Interpretation:

• Rate: 60
• Rhythm: NSR
• Axis: LAD (-30 to -90)
• Morphology:
  • anterolateral downsloping STD
  • discordant u waves V3-6
  • Q waves in leads II, aVF
• Intervals: PR200 QRS110
• Summary: Ischaemic ECG

Updates on U waves:

when normal

• axis similar to t wave
• amplitude <= 25% t wave
• duration of apex from t to u wave is aroun 0.1sec
• commonly monophasic and have a shorter ascent than descent

Further Reading – Textbook:

Chan TC, Brady WJ, Harrigan RA, Ornato JP, Rosen P. ECG in Emergency Medicine and Acute Care. Elsevier Mosby 2005.