# The patient's ECG shows a ______ complex, where the QRS duration is more than 120 milliseconds with a distinctive M-shaped pattern.

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=168415  
> language: ko  
> subject: Diseases of the circulatory system

## 문제

The patient's ECG shows a ______ complex, where the QRS duration is more than 120 milliseconds with a distinctive M-shaped pattern.

## 보기

1. fragmented **✔ 정답**
2. widened
3. normal
4. narrow
5. split

**정답: 1**

## 해설

A fragmented QRS complex with duration >120ms and M-shaped pattern is often seen in bundle branch blocks or ventricular conduction delays. This fragmentation represents disturbed ventricular activation due to scarring or conduction system disease.

## 임상 시나리오

ECG QRS Complex Characteristics:
- Normal QRS duration: 60-100ms
- Fragmented QRS: Multiple notches in QRS complex
- Causes of fragmented QRS:
* Myocardial scarring
* Bundle branch blocks
* Ventricular conduction delays
* Cardiomyopathy
- M-shaped pattern indicates:
* Conduction system disease
* Ventricular activation disturbance
- Clinical significance:
* Marker of myocardial fibrosis
* Predictor of cardiac events
* Associated with arrhythmias
- Assessment criteria:
* QRS duration >120ms
* Presence of notching
* RSR' pattern
* Multiple R waves

## 핵심 개념

- **fragmented** — broken or split into multiple parts, indicating disrupted electrical conduction in cardiac tissue
- **widened** — increased in width or duration, typically referring to extended QRS complex duration
- **normal** — within typical or standard parameters for ECG measurements and patterns
- **narrow** — having reduced width or duration, typically referring to QRS complex less than 120ms
- **split** — divided or separated into distinct components in ECG waveform pattern

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