ekg interpretation

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ekg interpretation ekg interpretation objectives the basics interpretation clinical pearls practice recognition the normal conduction system lead placement avf all limb leads precordial leads ekg distributions anteroseptal: v1, v2, v3, v4 anterior: v1–v4 anterolateral: v4–v6, i, avl lateral: i and avl inferior: ii, iii, and avf inferolateral: ii, iii, avf, and v5 and v6 waveforms interpretation develop a systematic approach to reading ekgs and use it every time the system we will practice is: rate rhythm (including intervals and blocks) axis hypertrophy ischemia rate rule of 300- divide 300 by the number of boxes between each qrs = rate number of big boxes rate 1 300 2 150 3 100 4 75 5 60 6 50 rate hr of 60-100 per minute is normal hr > 100 = tachycardia hr 0.2 sec second degree block, mobitz type 1 pr gradually lengthened, then drop qrs second degree block, mobitz type 2 …

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oventricular ventricular escape rhythm, 40-110 bpm seen in ami, a marker of reperfusion junctional rhythm rate 40-60, no p waves, narrow complex qrs hyperkalemia tall, narrow and symmetric t waves wellen’s sign st elevation and biphasic t wave in v2 and v3 sign of large proximal lad lesion brugada syndrome rbbb or incomplete rbbb in v1-v3 with convex st elevation brugada syndrome autosomal dominant genetic mutation of sodium channels causes syncope, v-fib, self terminating vt, and sudden cardiac death can be intermittent on ekg most common in middle-aged males can be induced in ep lab need icd premature atrial contractions trigeminy pattern atrial flutter with variable block sawtooth waves typically at hr of 150 torsades de pointes notice twisting pattern treatment: magnesium 2 grams iv digitalis dubin, 4th ed. 1989 lateral mi reciprocal changes inferolateral mi st elevation ii, iii, avf st depression in avl, v1-v3 are reciprocal changes anterolateral …

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$al tracts the standard limb leads standardization amv. a se q bipolar limb leads —> augmented unipolar limb leads 0 ave +90" +120" 160° septal == rr interval qrs complex titi riera 4 i j | | pr st h} gent {gear +t | “ i j at v at] ae -90° indeterminate lead avf positive negative positive normal lad axis lead! negative rap __ | indeterminate axis qrs qrs in lead in lead ave normal axis bois oe us = pie! pl > nge roi bllter et pees atel “ll cree heese reel eer restgs eee neil teste pal a a ate i aed se a a aia ad glia ie getre cnenss tues tele geel ceese ape ea ug se hace pe, | peledbbtbelnd eld yyspic eae 1 ob apr-i9h 181 (© 1997 frank g. yanowitz, m.d. ecgs for the emergency physician amal matta and william brady an …$

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resent: q rbbb qlbbb qlahb q lphb (ltt 12-lead ekg interpretation checklist (con't) hypertrophy check if present: qrae qlae orvh olh infarction check if present: o anterior mi q inferior mi q lateral mi q posterior mi q anteroseptal mi (1 extensive anterior (anterior-lateral) mi subendocardial mi q ischemia miscellaneous effects check if prese hyperkalemia 2 severe hyperkalemia 0 hypokalemia q hypercalcemia q hypocalcemia digitalis effect q quinidine effect

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ekg interpretation ekg interpretation objectives the basics interpretation clinical pearls practice recognition the normal conduction system lead placement avf all limb leads precordial leads ekg distributions anteroseptal: v1, v2, v3, v4 anterior: v1–v4 anterolateral: v4–v6, i, avl lateral: i and avl inferior: ii, iii, and avf inferolateral: ii, iii, avf, and v5 and v6 waveforms interpretation develop a systematic approach to reading ekgs and use it every time the system we will practice is: rate rhythm (including intervals and blocks) axis hypertrophy ischemia rate rule of 300- divide 300 by the number of boxes between each qrs = rate number of big boxes rate 1 300 2 150 3 100 4 75 5 60 6 50 rate hr of 60-100 …

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