How do I interpret this electrocardiogram (ECG)?

ECG Interpretation Assistance

I can help you interpret an ECG if you provide a photo, but you must understand that computer-assisted and AI interpretations are helpful adjuncts only—they should never replace qualified physician interpretation in clinical decision-making. 1, 2, 3

Critical Limitations You Must Understand

Any interpretation I provide requires mandatory verification by a qualified physician before making any patient management decisions. 2, 4, 3 Computer and AI-based ECG analysis accuracy ranges from 0-94% for various disorders, with arrhythmias being particularly problematic. 1, 3

• Major interpretation errors occur in 4-33% of cases even among trained physicians, though adverse patient outcomes from these errors are rare (<1% of interpretations). 1, 3
• Computer interpretations can provide accurate measurements of heart rate, intervals, and axes, but rhythm disturbances, ischemia, and infarction diagnoses require careful physician over-reading. 4
• Never accept any automated interpretation without physician verification—this is a critical safety requirement. 2, 4

How I Can Assist You

If you provide an ECG image, I can help you apply a systematic interpretation framework:

Systematic Approach I Will Use

Technical Quality Assessment:

• Verify adequate signal quality, proper electrode placement, and identify any artifacts that may affect interpretation. 2, 4
• Check for baseline wander, electrical interference, and adequate filtering settings. 2

Rate and Rhythm Analysis:

• Calculate heart rate (normal: 60-100 bpm in adults). 2, 4
• Identify underlying rhythm by confirming P waves before each QRS complex with consistent PR interval. 2, 4
• Note any irregularities such as premature beats, pauses, or irregular patterns. 2, 4

Interval Measurements:

• PR interval (normal: 120-200 ms) to assess AV conduction. 2, 4
• QRS duration (normal: <120 ms) to identify conduction delays. 2, 4
• QTc interval (normal: <450 ms men, <460 ms women). 2, 4

Axis Determination:

• Evaluate electrical axis using leads I and aVF (normal: both positive). 2, 4

Morphology Analysis:

• ST-segment deviations (elevation >0.1 mV limb leads or >0.15-0.2 mV precordial leads suggests acute injury). 2, 4
• T-wave abnormalities (inversion, hyperacute changes, flattening). 2, 4
• Pathological Q waves (>0.04 seconds or >25% of R wave amplitude). 2, 4
• Voltage criteria for chamber enlargement. 2

Essential Clinical Context Required

The ECG must always be interpreted in conjunction with the patient's clinical presentation—the same ECG pattern may have completely different implications depending on symptoms. 2, 4, 3

• Clinical signs and symptoms alone have insufficient sensitivity (35-38%) and specificity (28-91%) without ECG and biomarkers. 4
• You must provide relevant clinical information including: presenting symptoms (chest pain, dyspnea, palpitations, syncope), age, cardiovascular risk factors, and any prior cardiac history. 4, 5, 6

Important Caveats

• I cannot provide emergency medical advice—if this is an acute clinical situation requiring immediate decisions (suspected STEMI, life-threatening arrhythmia), obtain immediate in-person physician evaluation. 4
• Any interpretation I provide is educational only and requires verification by a physician with appropriate training (residency training with ACLS certification is considered sufficient for routine interpretation). 4, 3
• Comparison with previous ECGs is essential when available to identify dynamic changes—I cannot do this without access to prior tracings. 2, 4

Please upload the ECG image along with relevant clinical context, and I will provide a systematic educational interpretation that must be verified by a qualified physician before any clinical decisions are made.