Common%ECG%Patterns%(in%exams).%Prepared%by%Josh%Monester%2013.
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! I!have!taken!all!the!following!ECGs!from%LITFL!its!brilliant!!
http://lifeinthefastlane.com/ecgNlibrary/basics/diagnosis/!!
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Details! Rhythm! QRS!complex!
! ! Normal !
Previous!ECGs?! Axis! ST!segment!
! ! !
Technicalities! P!wave! T!wave!(+!U!wave)!
! ! !
Rate! PR!interval! Interpretation!
! ! !
!
!
Details! Rhythm! QRS!complex!
! ! Sinus !
Previous!ECGs?! Axis! arrhythmia ST!segment!
! ! !
Technicalities! P!wave! T!wave!(+!U!wave)!
! ! !
Rate! PR!interval! Interpretation!
!
Details! Rhythm! QRS!complex!
! ! sinus tachycardia !
Previous!ECGs?! Axis! (comes from the SA ST!segment!
! ! node) - no real fifix, !
Technicalities! P!wave! the patient's heart T!wave!(+!U!wave)!
! ! rate is high for no !
Rate! PR!interval! reason (seemingly) Interpretation!
!
Details! Rhythm! QRS!complex!
! ! !
Previous!ECGs?! Axis! Atrial fifibrillation ST!segment!
! ! !
Technicalities! P!wave! T!wave!(+!U!wave)!
! ! !
Rate! PR!interval! Interpretation!
!
!
Details! Rhythm! ST segment QRS!complex!
! ! depression in all of !
Previous!ECGs?! Axis! the leads means ST!segment!
! ! something is acting !
Technicalities! P!wave! on whole hard - omg T!wave!(+!U!wave)!
! ! digoxin?! digoxin is !
Rate! PR!interval! associated with a Interpretation!
! sloping, moustache
! appearance in ST
segment
Rhythm!strip!=!lead!II!
!
Details! Rhythm! QRS!complex!
! ! !
Previous!ECGs?! Axis! ST!segment!
! ! PR interval is !
Technicalities! P!wave! prolonged baby. shouldT!wave!(+!U!wave)!
! ! be shorter than 5 small !
Rate! PR!interval!squares. This is fifirst Interpretation!
degree heart block. !
Essentially the AV node!
is trying to stop the the !
depolarising messages
from atrium from
reaching the ventricles,
hence the delayed PR
interval
rhythm is regularly
!
Details! Rhythm! irregular because QRS!complex!
! ! there are four !
Previous!ECGs?! Axis! 'normal' QRS ST!segment!
! ! followed by a break. !
Technicalities! P!wave! PR interval is a bit T!wave!(+!U!wave)!
! ! over 5ss. It is a !
Rate! PR!interval! second degree Interpretation!
! heart block (type 1 -
! PR getting longer
until there is a single
miss of QRS
!
Details! Rhythm! QRS!complex!
! ! !
Previous!ECGs?! Axis! ST!segment!
! ! !
Technicalities! P!wave! T!wave!(+!U!wave)!
! ! !
Rate! PR!interval! Interpretation!
! at arrows there are no
! QRS complexes after
the P waves. regularly
irregular rhythm. second
degree heart block type
2 (normal PR interval but
every second or third
misses the QRS). In this
case it is a 3:1 but it is
usually 2:1.
QRS intervals are !
Details! Rhythm! wide (meaning more QRS!complex!
! ! likely to come from !
Previous!ECGs?! Axis! the ventricles). T ST!segment!
! ! waves are mostly !
Technicalities! P!wave! inverted. This is T!wave!(+!U!wave)!
! ! complete heart block !
Rate! PR!interval! (3rd degree) - no Interpretation!
relationship between
! atria and ventricles
!
Details! Rhythm! No visible P wave, so QRS!complex! This is also RAD
! ! it's not sinus ! because lead I is
Previous!ECGs?! Axis! tachycardia. The QRS ST!segment! negative.
! ! intervals are narrow ! Supraventricular
Technicalities! P!wave! meaning that it is more T!wave!(+!U!wave)!
tachycardias are
! ! likely to come from ! treated with
Rate! PR!interval!above the ventricles - Interpretation! adenosine.
therefore this is likely
supraventricular
tachycardia
!
Details! Rhythm! QRS!complex!
M pattern in V1
! ! !
(remember
Previous!ECGs?! Axis! ST!segment!
WiLLiaM
! ! MaRRoW) so !
Technicalities! P!wave! therefore it is right T!wave!(+!U!wave)!
! ! bundle branch !
Rate! PR!interval! block. Interpretation!
!
Details! Rhythm! This is left bundle QRS!complex!
! ! branch block (you !
Previous!ECGs?! Axis! can kind of see the ST!segment!
! ! V6 looks like an M). !
Technicalities! P!wave! The QRS are broad. T!wave!(+!U!wave)!
! ! !
Rate! PR!interval! Interpretation!
!
Details! Rhythm! QRS complexes are QRS!complex!
! ! pretty fucking broad, !
Previous!ECGs?! Axis! and it's pretty regular. ST!segment!
! ! There's tachycardia !
Technicalities! P!wave! also. As such, it's T!wave!(+!U!wave)!
! ! called ventricular !
Rate! PR!interval!tachycardia - it is Interpretation!
shockable.
It looks kind of like !
Details! Rhythm! atrial fifibrillation except QRS!complex!
! ! for the ventricles. It is !
Previous!ECGs?! Axis! ventricular fifibrillation, ST!segment!
! ! the patient is likely to !
Technicalities! P!wave! lose consciousness if T!wave!(+!U!wave)!
! ! they haven't already. !
Rate! PR!interval!Shockable also. Interpretation!
Lead I is positive, lead You can check this
Details! Rhythm! II is diffi
ficult to tell. ST QRS!complex! ST elevation by
! ! segment does appear ! checking the
Previous!ECGs?! Axis! to be elevated in lead II ST!segment! opposite side -
! ! so this indicates a ! e.g. you would
Technicalities! P!wave! myocardial infarction. T!wave!(+!U!wave)! expect aVL to be
! ! The fact that the ST ! depressed ST
Rate! segment
PR!interval! appears Interpretation! segment if II, III
elevated in II, III and and aVF are in
! aVF indicates it is an fact elevated.
! inferior STEMI.
!
Details! Rhythm! There is ST elevation QRS!complex!
! ! in lead I and aVL so !
Previous!ECGs?! Axis! initially we are already ST!segment!
! ! thinking it might be an !
Technicalities! P!wave! AMI of the lateral (left) T!wave!(+!U!wave)!
! ! side. We can then !
Rate! PR!interval!confifirm this checking Interpretation!
leads V5 and V6.
! Moreover there is
reciprocal ST
depression in leads III
and aVF.
