Understanding Your ECG / EKG Report

Bradycardia (<60 bpm)

Slow heart rate. Common in athletes, or can indicate conduction problems. May cause dizziness or fainting.

Tachycardia (>100 bpm)

Fast heart rate. Can be caused by anxiety, fever, anaemia, dehydration, hyperthyroidism, or heart arrhythmia.

Normal Sinus Rhythm

The heart beats regularly, initiated by the sinus node (the natural pacemaker). Each P wave is followed by a QRS complex.

Sinus Tachycardia

Normal sinus rhythm but fast (>100 bpm). Usually has a simple cause (fever, anxiety, exercise).

Atrial Fibrillation (AF)

Irregular, chaotic rhythm. No clear P waves. Increases stroke risk — discuss anticoagulation with your doctor.

Premature Beats (PVCs/PACs)

Occasional early beats. Usually benign (common in normal people), but frequent ones need evaluation.

Left Axis Deviation (LAD)

The heart's electrical impulse is shifted left. Can be normal in some people, or indicate left ventricular hypertrophy.

Right Axis Deviation (RAD)

Electrical impulse shifted right. Can be seen in lung disease, right ventricular hypertrophy, or as a normal variant.

Short PR (<120ms)

Pre-excitation syndrome (e.g. WPW). Electrical impulse bypasses the AV node.

Prolonged PR (>200ms)

First-degree AV block — the impulse is slowed between atria and ventricles. Usually benign if isolated.

Varying or absent PR

Higher-degree AV blocks. Second or third degree blocks require further evaluation.

Normal QRS (<120ms)

Electrical conduction through ventricles is normal speed.

Wide QRS (>120ms)

Bundle branch block (LBBB or RBBB) or ventricular rhythm. Always needs clinical evaluation.

Prolonged QTc

Risk of dangerous arrhythmia (Torsades de Pointes). Can be caused by medications, electrolyte imbalances, or inherited conditions.

Short QTc (<350ms)

Short QT syndrome — rare but associated with increased arrhythmia risk.

ST Elevation

EMERGENCY if new and in multiple leads — may indicate acute heart attack (STEMI). Call emergency services immediately.

ST Depression

May indicate ischaemia (reduced blood flow to heart muscle) or NSTEMI. Needs urgent evaluation.

T-wave Inversion

Can indicate ischaemia, right ventricular strain, or in V1–V3 may be normal variant in women.

"Normal ECG / Within normal limits"

No abnormalities detected at the time of recording. Does not rule out all cardiac conditions.

"Left Ventricular Hypertrophy (LVH)"

The left ventricle muscle appears thickened. Common in longstanding high blood pressure. Needs BP control.

"RBBB / LBBB"

Right or Left Bundle Branch Block. Electrical delay in one side. LBBB often more clinically significant.

"Ischaemic changes"

ST or T-wave changes suggesting reduced blood flow to heart muscle. Needs urgent evaluation.

"Old / Completed infarct"

Evidence of a previous heart attack (abnormal Q waves). The event already happened — focus on current symptoms.

"Non-specific ST-T changes"

Minor ST or T-wave changes that don't clearly fit a specific diagnosis. Common finding — correlate with symptoms.