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This is a 12-lead ECG of a 13-year-old boy presenting with tiredness. Based on the visual assessment, here's a structured interpretation:
Rate and Rhythm
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Rate: Normal (approx. 75–85 bpm).
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Rhythm: Regular sinus rhythm (P wave before each QRS, normal morphology, upright in leads I, II, aVF).
Axis
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The QRS axis appears to be normal (positive in leads I and aVF).
P Waves
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Present, upright in II – consistent with sinus rhythm.
PR Interval
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PR interval appears normal (~120–200 ms).
QRS Complex
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Narrow complexes: normal duration.
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Voltage criteria may suggest left ventricular hypertrophy (LVH):
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Tall R waves in V5–V6 and deep S waves in V1–V2.
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Possible voltage criteria met for LVH (common in adolescents and athletes, but can be pathological).
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ST Segment and T Waves
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No ST elevation or depression.
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T wave inversion in V1: Normal in adolescents (“juvenile T-wave pattern”).
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T waves are upright in lateral leads (V5–V6), normal.
QT Interval
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Appears within normal limits for age.
Interpretation Summary
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Normal sinus rhythm
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Possible LVH by voltage criteria (may be normal variant in adolescents, especially in athletic individuals)
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Juvenile T-wave pattern (normal variant)
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No ischemic changes, arrhythmias, or conduction blocks seen.
Clinical Considerations
Given the symptom of tiredness, consider:
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Physiologic LVH in athletic teens (if he is physically active).
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Pathologic LVH (e.g., hypertrophic cardiomyopathy – HCM) if family history of sudden cardiac death, syncope, or abnormal echocardiogram.
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Further workup: Echocardiography is warranted to assess for structural heart disease, especially if clinical suspicion for HCM exists.
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Lab tests: CBC (anemia), thyroid function, and possibly viral serologies depending on context.
Would you like help drafting a referral or request for a pediatric cardiology evaluation or echocardiogram?
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