ECG Handouts
ECG Handouts
ECG Handouts
Positive Vector
• Left
• Down
QRS COMPLEX
6 MAJOR WAVES IN ECG Ventricular contraction
Normal: <0.10 sec
Q wave
Lead II & avF
○ <0.04 sec wide
○ <2mm deep
○ <25% of succeeding R wave
P WAVE
Atrial contraction
Upright in Lead I, II and avF
Normal: 0.12 – 0.20 sec
REGULAR RHYTHM
RATE/MIN = 1500/# of small squares
IRREGULAR RHYTHM
RATE/MIN = # QRS COMPLEXES X 10
30 BIG BOXES (6 second strip)
QT Corrected
QT Actual
• RATE/MIN = 12 X 10 = 120
√ R − R Interval
ECG READING RHYTHM
Normal : REGULAR SINUS RHYTHM
Male < 0.48
Female < 0.44
T WAVE
Rapid phase of repolarization
Usually not >10mm in the precordial leads
Prolonged PR interval
SINUS BRADYCARDIA
SUPRAVENTRICULAR TACHYCARDIA (AVNRT)
ATRIAL FLUTTER
ATRIAL FIBRILLATION
Discernible P wave
Prematurely occurring PQRST complex
Irregular R-R interval
P wave different in configuration in sinus beat
QRS complexes usually normal
PR interval often long
QRS narrow
VENTRICULAR TACHYCARDIA
Rapid, bizarre wide QRS complex
No P wave (ventricular impulse) No P wave (Ventricular impulse origin)
Wide QRS complex
VENTRICULAR FIBRILLATION Pacemaker spike precedes the wide QRS complex
INFERIOR WALL MYOCARDIAL INFARCTION ST segment elevation NOT fulfilling criteria for ST-
Elevation MI
HYPOKALEMIA
Tall R in V1
ST depression & upright T waves in V1 to V4
Wide & deep Q with ST elevation in V7 to V9
MYOCARDIAL ISCHEMIA
PERICARDIAL EFFUSION
S1Q3T3
PERICARDITIS