Study Notes –ECG & Clinical Assessment

ECG Findings

• PR interval: 0.20 sec → Upper limit of normal (monitor for 1° AV block)

• QRS interval: 0.09 sec → Normal

• QT interval: 0.54 sec → Prolonged

• QTc interval: 0.52 sec → Markedly prolonged (critical)

• RR interval: 1.06 sec → HR ≈ 57 bpm (bradycardic range)

Peripheral Neurovascular Exam

• WDL (within defined limits) → Normal perfusion, sensation, and movement

Clinical Significance

• Prolonged QTc (>0.47 M, >0.45 F):

  • ↑ Risk of Torsades de Pointes → may progress to sudden cardiac arrest

  • Causes: drugs (antiarrhythmics, macrolides, antipsychotics), electrolyte imbalance (↓K⁺, ↓Mg²⁺), congenital long QT

  • Management:

    • Stop QT-prolonging drugs

    • Correct electrolytes (K⁺, Mg²⁺)

    • Continuous cardiac monitoring

    • If unstable → IV Mg²⁺, pacing, or defibrillation

• PR interval at upper limit:

  • May signal early conduction delay → monitor for 1° AV block

• Normal neurovascular exam:

  • Rules out acute limb issues (compartment syndrome, DVT, arterial occlusion, nerve compression)

Takeaway

• Critical finding = Prolonged QTc (0.52 sec) → immediate risk of lethal arrhythmias.

• Next steps: Urgent evaluation, identify/reverse cause, close monitoring.