My 12-lead

[AZCEP]

The QRS is only slightly longer than the textbook 0.10 sec so there may be an interventricular delay but nothing of clinical significance. Bundle branch blocks are usually defined as greater than 0.12 sec so that's out.

The QRS axis is still within the normal range if shifted a bit toward the left, but not enough to be concerned with. WPW might be a consideration, but the delta wave is usually identifiable in the chest leads as well.

[fiznat]

Your abbarancy could be a whole host of things, most likely ranging somewhere between the unimportant to the irrelevant. You don't have the clinical signs of any actual pathology, and to be honest I wouldn't be surprised if the ECG were to be taken again, you might not even see those rabbit ears.

My ECG instructor taught me a phrase for these kinds of situations: "one of something is one of nothing." In order to identify real disturbances, you're going to need to see the effect in more than one place. You'll need to see the effects of that pathology reflected in other areas. To see "something" in one spot is usually small enough to simply ignore.

[AnthonyM83]

AZCEP, where did you see the axis deviation? (I'm still trying to self-learn these things...with Mr. Dubin's help)

[chbare]

I think AZCEP was stating the axis was normal. It was just a little to the left in the normal range. The R axis is 15. This is within the normal axis range. 0 to -30 would put you in the physiologic LAD range, so 15 is a little closer to the left.

Overall, the 12 lead looks pretty unremarkable.

Take care,

chbare.

[scratrat]

I see the rabbit ears you are talking about in III and AVF, which would be indicative of an LBBB but I just don't think they are wide enough. LBBB's or any branch block tend to be wider. I could be wrong, hopefully we can get one of the Docs to weigh in.

Not wide enough. Plus, you need to look at V1 to determine if it is in fact a BBB. V1 isn't too bad, so it's probably normal variant. Although your V leads look like you're coming close to having LVH (left ventricular hypertrophy). Not there yet, but it looks like they are getting there.

[akroeze]

Not wide enough. Plus, you need to look at V1 to determine if it is in fact a BBB. V1 isn't too bad, so it's probably normal variant. Although your V leads look like you're coming close to having LVH (left ventricular hypertrophy). Not there yet, but it looks like they are getting there.

Hmmmm, causes for a 23 year old?

[ERDoc]

Looks like a pretty normal EKG. The axis is normal (use calipers and you will see). The is absolutely no BBB. For a RBBB, look in V1, V6 and I. V1 will have the RSr' and v6 and I will show slurring of the S wave, both of which are absent. There is no evidence of LVH either. There are some prominent waves in the precordium, but this is most likely normal (assuming you have a normal habitus).

Looking strictly at the EKG, I do not see anything overly concerning.