Case 11 — Electrocardiogram

ECG recording of three limb leads (I, II, III). Calibration is 1 cm = 1 mV. Paper speed is 25 mm/second. The fourth and second-to-last complexes are premature with abnormal orientation, wider QRS complexes, and T waves opposite in polarity — consistent with premature ventricular complexes.
Three-lead ECG (I, II, III; 25 mm/s). The 4th and second-to-last complexes are premature, abnormally oriented, wider than normal, with opposite T-wave polarity — consistent with PVCs.

Quiz

1. How would you characterize the fourth and second-to-last complexes?

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