Case 42: A 57-Year-Old Woman for Annual Check-up
History
Diagnosis
History
A 57-year-old woman with no cardiac symptoms and good exercise tolerance, is at her family doctor’s office for her annual check-up, including a routine ECG:
Diagnosis
- Unusual P axis, possible ectopic atrial rhythm otherwise, a normal ECG
The P wave is positive in lead I and negative in II, III and aVF (the P axis is between -30 and -60 degrees), in keeping with an ectopic pacemaker located in the lower atrial region (possibly of the right atrium). The PR interval is 120 msec.
Ectopic atrial rhythm may be seen both in individuals without structural heart disease and in cardiac patients. It is usually transient. If PR interval is <120 msec. the diagnosis of junctional rhythm is made.
ECG ID: E181