Do Nausea and Vomiting Have Cardiac Cause?

ANSWER
The correct interpretation of this ECG includes normal sinus rhythm, left atrial enlargement, and nonspecific T-wave abnormalities.

Normal sinus rhythm is evidenced by an atrial and ventricular rate of 77 beats/min with one-to-one association. Left atrial enlargement is evidenced by the presence of a biphasic P wave in lead V₁ with a negative terminal portion of the P wave ≥ 1 mm². (P waves in lead I ≥ 110 ms are also seen in left atrial enlargement, but are not evident in this ECG.) The small or inverted appearance of T waves in the inferior and lateral leads indicates nonspecific T waves. 

These ECG findings are typical of patients with mitral valve disease, but were of no benefit in diagnosing acute pancreatitis in this patient. By the time she had the ECG done, she had been given sedation sufficient to reduce her heart rate from the 118 beats/min it had been at the time of examination.