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EKG (ECG) Interpretation

This is the EKG (ECG) for Maria Perez from scenario SIE004US

Clinical Picture

  • 80-year-old woman, complaining of being lightheaded.
  • Previous cardiac issues noted, with extensive past medical history.
  • Looks tired and anxious.



  • Rate: 55
  • Rhythm: Irregular
  • Axis: Normal
  • Waves and intervals: Gradual increase in P-R interval



  • The EKG shows second-degree heart block, type 1.


Differential diagnosis

  • In a patient with cardiac issues, presenting with lightheadedness and a gradual increase in P-R interval on EKG, indicates a differential of 2nd degree heart block type 1. A myocardial infarction would show more significant EKG changes. Complete heart block would show the electrical signal can’t pass normally from the atria. Pericarditis is likely to present over a period of more than two days, and there is no evidence of GI reflux symptoms.



  • In this case, atropine is needed, to increase heart rate through vagolytic effects, causing an increase in cardiac output.


Further reading



  1. Wagner, P., Strodthoff, N., Bousseljot, R., Samek, W., & Schaeffter, T. (2020). PTB-XL, a large publicly available electrocardiography dataset (version 1.0.1). PhysioNet
  2. Wagner, P., Strodthoff, N., Bousseljot, R.-D., Kreiseler, D., Lunze, F.I., Samek, W., Schaeffter, T. (2020), PTB-XL: A Large Publicly Available ECG Dataset. Scientific Data
  3. Goldberger, A. et al. (2000). PhysioBank, PhysioToolkit, and PhysioNet: Components of a new research resource for complex physiologic signals. Circulation [Online]. 101 (23), pp. e215–e220.