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Basic ECG interpretation

A presentaion used to train medical students in basic ECG interpretation

Gregg Morris

on 1 May 2013

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Transcript of Basic ECG interpretation

P wave Atrial depolarization
<2.5mm amplitude
<0.12 sec (3 squares)
1:1 association with a QRS QRS Ventricular depolarisation
<0.12 sec
Composition and polarity vary depending on lead viewed T wave Ventricular repolarization
Negative T waves in V1, SIII and aVR can be normal
Always remember... 1500/R-R interval
(Small squares)

<60 = bradycardia
>100 = tachycardia Rate Axis Regular
Irregularly irregular
Regularly irregular Look at SI and SIII
Reaching towards = Right
Leaning away = Left Rhythm 1:1 association
Height + duration
Axis P wave 0.12-0.20 sec
Consistent PR interval <0.12 sec duration
Amplitude QRS T & ST Elevated/depressed
Morphology Atrial fibrillation - No P waves + irregular ventricular rate Right atrial hypertrophy - P > 2.5mm "peaky P's" Left atrial hypertrophy - P > 0.12 sec in SII "P mitrale" Mobitz I (Wenckebach) - ? 1:1 conduction ?
- Lengthening PR interval
- Intermittent non conducted P's 1st degree AV block - Long PR interval Mobitz II - ? 1:1 conduction ?
- PR same
- Intermittent non conducted P's Complete AV block - ? 1:1 conduction ?
- Atrial + Ventricular rate independent RBBB - QRS > 0.12 sec
- RSR morphology in V1 LBBB - QRS > 0.12 sec
- Wide bizarre QRS WPW - Delta wave
- Short PR interval LVH - S wave in V1 + R wave in V5 or V6 = >35mm Atrial flutter - Saw tooth flutter waves Pericarditis - Widespread "saddle shaped" ST elevation
- May have PR depression Acute MI - ST elevation V1-V4
- reciprocal depression in SII, III and aVF Acute MI - ST elevation SII, SIII and aVF
- reciprocal depression V1-V3 Brugada - Coved ST segment elevation V1-V3
- RBBB HOCM Hyperkalaemia - Deep T wave inversion in precordial leads + LVH - Tall peaked T waves
- slurred QRS References http://ecg.utah.edu/img_index
http://openi.nlm.nih.gov/detailedresult.php?img=2628935_1752-1947-3-5-1&req=4 Quick quiz Asystole - Lack of cardiac activity VF - Rapid irregular ventricular rhythm Inferior Lateral Septal Anterior Normal Sinus Rhythm 60/R-R interval (ms)


number of QRS's on ECG x 6
Full transcript