Cardiologist Questions

Ecg

On my ecg, p-r-t axes are shown as 76 77 25 what does this mean & also a nonspecific t wave abnormality.

Female | 38 years old
Medications: Cobalamin
Conditions: Pernicious anemia

1 Answer

Nothing!.. do not get caught up in ECG jargon. Those numbers represent the direction of the electrical vectors for p-wave (atrial depolarization) qrs (ventricular depolarization) and t wave (ventricular depolarization). The directional vectors are influenced by various cardiac conditions and pathological states ( hypertrophy, scarring from MI, etc). Those numbers on your ecg represent normal quadrants. But to understand the details and nuances of ECGs requires 3 years of cardiovascular fellowship training. And non specific T waves are just that. Non-specific. It tells nothing and many people with normal hearts have insignificant T- wave changes. Forget the ECG. Its a piece of information thats very nonspecific. I have patients with terrible heart disease and heart failure, who have normal ECGs. And vice versa, those who have really ugly ECGs and absolutely normal heart muscle. Cardiologist rely on echocardiograms images (ultrasound) to evaluate patients for structural heart disease. Because ECG leads measure amplitude and direction of the electrical conduction system of the heart. Those electrical vectors are affected by tissue, bone, etc (obesity, breast size, small patients) and age ( younger have higher amplitude) , in addition to cardiac abnormalities. And lead placement can also make the ECG abnormal. 12 leads are attached to the chest and misplaced leads can give the ecg the appearance of a previous MI So , your ECG is normal, like most 38 year old females. We dont see many abnormalities in young, otherwise healthy, females unless they were born with some form of congenital heart disease. I read between 5-10k ecg per year. More than 80% of those from the ER are completely normal or represent normal variants (like yours). Unless we capture an arrhythmia or do an ECG during an acute cardiac syndrome (MI), most are unremarkable. We dont rely