20 practice 1
TRANSCRIPT
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12-Lead 12-Lead ElectrocardiographyElectrocardiography
a comprehensive course
Adam Thompson, EMT-P, A.S.Adam Thompson, EMT-P, A.S.
Practice-
1
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Practice
• Lets take a look at a 12-Lead recording and use the 6-step method to interpret it.
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62 y/o MaleComplaining of Chest Pain
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62 y/o MaleRate & Rhythm
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62 y/o MaleAxis
Rate: 88Normal Sinus
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62 y/o Male
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62 y/o MaleAxis
Rate: 88Normal Sinus
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62 y/o Male
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Hexaxial Reference System
• When the mean axis is perpendicular to the positive electrode, the QRS is equiphasic.
+
+
+ A B A
B
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62 y/o Male
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62 y/o MaleAxis
Rate: 88Normal Sinus
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62 y/o Male
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62 y/o Male
ERAD LAD
RAD Normal
180 0
-90
90
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62 y/o MaleAxis
Rate: 88Normal SinusFrontal Axis: 30
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Precordial Axis
V1
V2
V3
V4
V5V6
Normal transition
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62 y/o MaleAxis
Rate: 88Normal SinusFrontal Axis: 30
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62 y/o MaleIntervals & Morphology
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: Normal
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62 y/o MaleIntervals & Morphology
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: Normal
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62 y/o MaleIntervals & Morphology
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: Normal
HyperacuteT-Waves
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62 y/o MaleSTE-Mimics
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
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62 y/o MaleSTE-Mimics
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
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62 y/o MaleSTE-Mimics
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
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62 y/o MaleSTE-Mimics
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
Lead I
lateral
aVR V1
septal
V4
anterior
Lead II
inferior
aVL
high lateral
V2
septal
V5
low lateral
Lead III
inferior
aVF
inferior
V3
anterior
V6
low lateral
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62 y/o MaleIschemia, Injury, Infarct
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
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62 y/o MaleIschemia, Injury, Infarct
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
Site Facing Reciprocal
Septal V1, V2 None
Anterior V3, V4 None
Lateral I, aVL, V5, V6 II, III, aVF
Inferior II, III, aVF I, aVL
Posterior V7, V8, V9 V1, V2
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62 y/o Male12-Lead #2
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
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62 y/o Male
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-wavesAntero-Septal MI
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Keep Practicing!!