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ECG Interpretation Cheat Sheet

The document provides an overview of electrocardiogram (ECG) interpretation, outlining various components of the ECG tracing and their clinical significance. It describes how to assess rhythm, rate, cardiac axis, P waves, QRS complex, ST segment, T waves, and U waves. Abnormal findings are associated with conditions like myocardial infarction, arrhythmias, conduction blocks, cardiomyopathies, and electrolyte imbalances.

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hirsi200518
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66K views

ECG Interpretation Cheat Sheet

The document provides an overview of electrocardiogram (ECG) interpretation, outlining various components of the ECG tracing and their clinical significance. It describes how to assess rhythm, rate, cardiac axis, P waves, QRS complex, ST segment, T waves, and U waves. Abnormal findings are associated with conditions like myocardial infarction, arrhythmias, conduction blocks, cardiomyopathies, and electrolyte imbalances.

Uploaded by

hirsi200518
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as PDF, TXT or read online on Scribd
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put together by Alex Yartsev: Sorry if i used your images or data and forgot to reference you.

Tell me who you are. [email protected]

ECG Interpretation
1) RHYTHM: regular, regularly irregular, irregularly irregular 2) RATE: tachy or brady 4) CARDIAC AXIS DEVIATION: S greater than R in lead I = RIGHT AXIS S greater than R in lead II = LEFT AXIS
PR = 1 big square

Max QRS = 3 small squares

Lead II looks from the NORMAL DIRECTION

3) P wave =atria depolarising

QRS in lead I is

should be 1 P for every QRS: smaller and in lead II How many Ps per QRS? is bigger on inspiration How long is the PQ interval? irregular P with irregular rhythm QRS = AF absent P with wide QRS = Ventricular Tachy absent P with narrow QRS = Junctional Tachy continuos undulating sawtooth baseline P = Atrial Flutter continuos with 2P per 1 QRS = Atrial Tachy with block

inf. view V1, V2 = Rt Heart V3, V4 = Septum V5, V6 = Lt Heart


II, III, aVF

Evolution of an infarct:
ST Q wave 12hrs later T inversion

bifid Long P waves = LA enlargement peaked tall P waves = RA enlargement normal rate, 2Ps per QRS = second degree block Progressive PQ lengthening = second degree block Long PQ interval = first degree block Ps dont match to QRS, very brady = complete block No P wave but a solitary QRS = ventricular extrasystole Long P = LAH; RSR = RBBB; ST Depression = Demand ischaemia 4) Q wave =septum depolarising or hole in conduction pattern
HOW BIG? Normal unless large, Big Q wave = Infarct in the direction of THAT LEAD

P is the HEART BLOCK WAVE P is also the ENLARGED ATRIUM WAVE Q is the INFARCT WAVE QRS is the CARDIAC AXIS COMPASS ST is the ISCHAEMIA SEGMENT T is the HYPERKALEMIA WAVE U wave is the HYPOKALEMIA WAVE

5) QRS =ventricles depolarising;

HOW BIG? Normal under 25mm, HOW WIDE? Hyperkalemia, BBB The higher the Ca++ DEFORMED QRS? The shorter the QT Huge tall QRS = LV hypertrophy Weak little QRS = old infarcted muscle RSR pattern (M) in V1 = Right Bundle Branch Block LBBB SRS pattern (W) in V1= Left Bundle Branch Block

RBBB

A Delta wave (gently up-sloping R) = = Wolff-Parkinson-White Syndrome 6) ST SEGMENT:


DEPRESSED OR ELEVATED? Biggest ST points to the lesion V1 Depressed = demand ischaemia, elevated = supply ischaemia Down-sloping ST = Digoxin therapy CONCAVE ST elevation in all leads, with elevated PR in aVR pericarditis
V6

7) T wave =ventricles repolarising


TALL? INVERTED?? WITH U WAVE??? inverted = infarct in last 24 - 48 hrs; without Q waves = Subendocardial infarct continuously painlessly inverted = LV hypertrophy with U wave = HYPOKALEMIA Tall T waves, Wide QRS, no ST segment = HYPERKALEMIA

9) U wave
just a little bump on the end of the T wave = HYPOKALEMIA

Wolff-Parkinson-White syndrome

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