Heart Rhythm Community
12.1k Members
Avatar universal

What do the notched S wave in lead III and the rsR' complex in lead avF mean?


I had this ECG done at the ER last week, I presented with symptoms of chest tightness and ache, shortness of breath, dizzy spells and a sensation of irregular heart beat. On the same day, in the morning, I woke up with epigastric discomfort and shortly thereafter I felt what seemed to be an episode of tachycardia, followed by nausea, shivers and the symptoms outlined above. The symptoms persisted and at night I went to the ER. Normal BP and heart rate on admission. I was referred for an ECG, told it was normal and my symptoms were anxiety-related. I was given 10 mg of diazepam and discharged.  

However, after examining my ECG, I find it a bit bizarre, especially on leads III and avF. This said, my question is: what do the nothed S wave in lead III and the rsR' complex in lead aVF mean? Should I worry and see my cardiologist as soon as possible?

Additional data:
- 29 year-old male;
- Diagnosed anxiety/panic disorder in 2006;
- ECG, stress test, echocardiogram, 24-hour holter monitoring and blood tests OK in August this year;
- No known cardiovascular disease;
- Height 5'9'', 205 lbs;  
- Taking a low-dose of beta-blocker daily and a benzodiazepine when needed.

Thank you.
2 Responses
86819 tn?1378951092
Yeah, I'd go see the cardiologist about this, just to get another set of eyes on it. Especially, if you have any questions that you would like answered.

Just my feeling here based on having a few troubles myself. I think I get a different opinion and learn something new every time I talk to someone. It may be worth seeing the doctor on that basis alone.

You'll have to make a priority call on the urgency though. You could call their office and describe your situation. They might be able to tell you whether you need to come in and how urgent that might be. Or if you think you would just feel better doing it ASAP, then do it. No harm in that.

Be sure to familiarize your self with angina symptoms so you can recognize a problem. If you have more serious symptoms, 911 is the right choice.

Avatar universal
Hi, I know it's been some time in between drinks as they say however I am experiencing pretty much the exact same symptoms with from you described a similar 'normal' but also slightly abnormal ecg with those notches you described. I am seeing a cardiologist in a few days about this but did you get any answers?
Have an Answer?
Top Arrhythmias Answerers
1807132 tn?1318747197
Chicago, IL
1423357 tn?1511089042
Central, MA
Learn About Top Answerers
Didn't find the answer you were looking for?
Ask a question
Popular Resources
Are there grounds to recommend coffee consumption? Recent studies perk interest.
Salt in food can hurt your heart.
Get answers to your top questions about this common — but scary — symptom
How to know when chest pain may be a sign of something else
A list of national and international resources and hotlines to help connect you to needed health and medical services.
Here’s how your baby’s growing in your body each week.