The ECG Made Easy

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Observe the distribution of the T wave inversion (e.g. anterior/lateral/posterior leads). You must take this ECG finding and apply it in the clinical context of your patient. Inverted T wave Biphasic T waves Right axis deviation (RAD) involves the direction of depolarisation being distorted to the right (between +90º and +180º). ST-elevation is significant when it is greater than 1 mm (1 small square) in 2 or more contiguous limb leads or >2mm in 2 or more chest leads. The lead with the most positive deflection is most aligned with the direction the heart’s electrical activity is travelling.

Understanding an ECG | ECG Interpretation | Geeky Medics Understanding an ECG | ECG Interpretation | Geeky Medics

An easy to follow systematic approach, along with colour coding and inline links to a wealth of #FOAMed ECG resources, creates a simple and incredibly effective learning tool.In healthy individuals, the electrical activity of the heart begins at the sinoatrial node then spreads to the atrioventricular (AV) node. It then spreads down the bundle of His and Purkinje fibres to cause ventricular contraction. RAD is commonly associated with conditions such as pulmonary hypertension, as they cause right ventricular hypertrophy. RAD can, however, be a normal finding in very tall individuals. Right Axis Deviation Left axis deviation A single Q wave is not a cause for concern – look for Q waves in an entire territory (e.g. anterior/inferior) for evidence of previous myocardial infarction. An example of a pathological Q wave R and S waves Amjid Rehman has created an innovative, interactive online application to assist in honing and refining your ECG interpretation skills. The atrial impulse is getting to the ventricle by a faster shortcut instead of conducting slowly across the atrial wall. This accessory pathway can be associated with a delta wave (see below).

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Benign early repolarisation occurs mostly under the age of 50 (over the age of 50, ischaemia is more common and should be suspected first). Simply, the P wave originates from somewhere closer to the AV node, so the conduction takes less time (the SA node is not in a fixed place, and some people’s atria are smaller than others).

Whenever the direction of electrical activity moves towards a lead, a positive deflection is produced. The ST segment is an isoelectric line representing the time between depolarisation and repolarisation of the ventricles (i.e. ventricular contraction). T wave An ECG lead is a graphical representation of the heart’s electrical activity which is calculated by analysing data from several ECG electrodes. Poor progression (i.e. S > R through to leads V5 and V6) can be a sign of previous MI but can also occur in very large people due to poor lead position. An example of poor R wave progression due to a previous anteroseptal MI. 1 J point segment

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Count the number of complexes on the rhythm strip (each rhythm strip is typically 10 seconds long). It’s important to understand which leads represent which anatomical territory of the heart, as this allows you to localise pathology to a particular heart region.Each deflection (a.k.a. wave) on the ECG represents the average direction of electrical travel (calculated using the ECG machine’s mathematical formulae). If P waves are absent and there is an irregular rhythm, it may suggest a diagnosis of atrial fibrillation. A pathological Q wave is > 25% the size of the R wave that follows it or > 2mm in height and > 40ms in width.

How to Read an ECG | ECG Interpretation | EKG | Geeky Medics How to Read an ECG | ECG Interpretation | EKG | Geeky Medics

VitalSource Bookshelf gives you access to content when, where, and how you want. When you read an eBook on VitalSource Bookshelf, enjoy such features as: how many times have you revised ‘ how to interpret an ECG‘? For me, it’s at least annually for the last 20 years, and still, I forget! Amjid Rehman These become larger the slower the bradycardia – classically U waves are seen in various electrolyte imbalances, hypothermia and secondary to antiarrhythmic therapy (such as digoxin, procainamide or amiodarone). U wave You may also be interested in our ECG interpretation OSCE stations available as part of our collection of 800+ ready-made OSCE stations.

An ECG lead is a graphical representation of the heart’s electrical activity calculated by analysing data from several ECG electrodes. Chest leads The cardiac axis gives us an idea of the overall direction of electrical activity. ECG leads Normal cardiac axis Provides a full understanding of the ECG in the diagnosis and management of abnormal cardiac rhythms. The mythical ‘ delta wave‘ indicates that the ventricles are being activated earlier than normal from a point distant from the AV node. The early activation then spreads slowly across the myocardium, causing the QRS complex’s slurred upstroke. The ECG abnormalities do not change! During a STEMI, the changes will evolve – in benign early repolarisation, they will remain the same.