ec gs for medical student
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All what you need to All what you need to know about EKGknow about EKG
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Each lead looks at the heartEach lead looks at the heart
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Normal waves and segments Normal waves and segments
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Reading ECGReading ECG
RhythmRhythm Rate Rate Axis Axis Chamber enlargement Chamber enlargement Ischemia ( ST, T, Q and LBBB)Ischemia ( ST, T, Q and LBBB) Intervals ( PR, QRS, QT) Intervals ( PR, QRS, QT) Conclusion Conclusion
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Normal ECGNormal ECG Each P is followed by QRSEach P is followed by QRS P wave is + in I and AVLP wave is + in I and AVL Rate is between 60-100Rate is between 60-100 P wave is less than 2.5 mm in height and P wave is less than 2.5 mm in height and
less than 0.11 mm in width less than 0.11 mm in width PR interval 0.12-0.2 mmPR interval 0.12-0.2 mm Normal QRS less 0.12 mmNormal QRS less 0.12 mm Normal QT is 0.42 mmNormal QT is 0.42 mm Normal ST is isoelectric with PR or TP Normal ST is isoelectric with PR or TP
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AxisAxis
both I and aVF +ve = normal axis both I and aVF -ve = axis in the Northwest Territory
lead I -ve and aVF +ve = right axis deviation
lead I +ve and aVF -ve lead II +ve = normal axis lead II -ve = left axis deviation
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Rate Rate
Or 300 divided by the Or 300 divided by the number of the large number of the large squares divided squares divided
Or number of the Or number of the QRSs multiplied by QRSs multiplied by 10 (AF)10 (AF)
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Right atrial enlargementRight atrial enlargement P wave 3 mm ( 3 small P wave 3 mm ( 3 small
squares) or greater in squares) or greater in height in inferior leadsheight in inferior leads
P wave 1.5 mm (1.5 small P wave 1.5 mm (1.5 small squares ) or greater in squares ) or greater in lead V1lead V1
The P wave has a sharp The P wave has a sharp and peaked appearanceand peaked appearance
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Left atrial enlargementLeft atrial enlargement
P wave notched and P wave notched and exceeds 120 ms ( 3 exceeds 120 ms ( 3 small squares) in the small squares) in the inferior leadsinferior leads
The negative terminal The negative terminal component of P wave component of P wave in V1 exceeds 40 ms in V1 exceeds 40 ms ( 1 small squares )( 1 small squares )
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Left ventricular hypertrophyLeft ventricular hypertrophy
S in lead V1 plus R in S in lead V1 plus R in either V5 or V6 either V5 or V6 greater than 35 mmgreater than 35 mm
R wave in lead aVL R wave in lead aVL greater than 11 mmgreater than 11 mm
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Right ventricular hypertrophyRight ventricular hypertrophy
Right axis deviationRight axis deviation
Dominant R in V1Dominant R in V1
RAERAE
R wave 7 mm ( 7 R wave 7 mm ( 7 small squares) or small squares) or greatergreater
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38 y M with CP38 y M with CP
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67y F HD CP at 0400am 67y F HD CP at 0400am
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65 y M with 1h CP65 y M with 1h CP
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45y M CP for 13 h vitals stable 45y M CP for 13 h vitals stable
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59 y F with 5h CP59 y F with 5h CP
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56 y M with 3h CP56 y M with 3h CP
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45 y M with 3h CP 45 y M with 3h CP
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62 y F with 45 min CP62 y F with 45 min CP
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59 y F 4h CP and BP 65/4059 y F 4h CP and BP 65/40
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63 y F 5h CP BP 64/3263 y F 5h CP BP 64/32
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