Dr A Röschl's picture
Submitted by Dr A Röschl on Mon, 07/31/2023 - 04:17

Here is the ECG of a 3-year-old boy. Is there cause for concern? The ECG shows a sinus rhythm with significant sinus arrhythmia. The heart rate increases with inspiration and decreases with expiration, which is called respiratory sinus arrhythmia. The QRS-axis is between 60 and 90 degrees, which is physiological at this age. The negative T-waves in V1-V3 (V4) are also age-appropriately normal. Therefore, there is no reason for concern; the ECG is considered normal for the child's age.

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Dawn's picture

Submitted by Dawn on Mon, 07/31/2023 - 12:09

It has been my experience that too many people evaluate pediatric ECGs using "adult" standards. For example, it is not widely understood that babies have inverted precordial T waves that gradually disappear as the child ages. Also, young adult ECGs are different from elderly adult ECGs. I hope you will post more interesting pediatric ECGs.

Dawn Altman, Admin

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