ECG of the Week 18th May 2022 Answer

A 22 year old female presents to ED with palpitations and chest discomfort 2 weeks post contracting COVID19. Below is the patients ECG:

Describe and Interpret the ECG

Answer

Rate:

Mean Ventricular rate: 66 beats per minute

Rhythm:

Bigeminy – sinus complexes followed by PVC – 1:1 relationship

Axis:

Inferior axis

Intervals – sinus complexes

PR: 160ms

QRS: 90ms

Additional:

V1- V2 slight ST elevation (native rhythm)

Wondering baseline

Appropriate discordance of the QRS and ST segments of the PVC’s

COVID19 can affect the heart in a number of ways, including:

Cardiac effects can persist for some weeks post infection. Therefore, in this case it would still be important to exclude peri myocarditis.

References:

Emrap.org Corependium

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

Emergucate