1. All what you need to
know about EKG

5. Each lead looks at the heart

6. Normal waves and segments

7. Reading ECG
 Rhythm
 Rate
 Axis
 Chamber enlargement
 Ischemia ( ST, T, Q and LBBB)
 Intervals( PR, QRS, QT)
 Conclusion

8. Normal ECG
 Each P is followed by QRS
 P wave is + in I and AVL
 Rate is between 60-100
 P wave is less than 2.5 mm in height and
less than 0.11 mm in width
 PR interval 0.12-0.2 mm
 Normal QRS less 0.12 mm
 Normal QT is 0.42 mm
 Normal ST is isoelectric with PR or TP

9. Axis
both I and aVF +ve = normal axis
both I and aVF -ve = axis in the
Northwest Territory
lead I -ve and aVF +ve =
right axis deviation
lead I +ve and aVF -ve
lead II +ve = normal axis
lead II -ve = left axis deviation

10. Rate
 Or 300 divided by the
number of the large
squares divided
 Or number of the
QRSs multiplied by
10 (AF)

11. Right atrial enlargement
 P wave 3 mm ( 3
small squares) or
greater in height in
inferior leads
 P wave 1.5 mm (1.5
small squares ) or
greater in lead V1
 The P wave has a
sharp and peaked
appearance

12. Left atrial enlargement
 P wave notched and
exceeds 120 ms ( 3
small squares) in the
inferior leads
 The negative terminal
component of P wave
in V1 exceeds 40 ms
( 1 small squares )

13. Left ventricular hypertrophy
 S in lead V1 plus R in
either V5 or V6
greater than 35 mm
 R wave in lead aVL
greater than 11 mm

14. Right ventricular hypertrophy
 Right axis deviation
 Dominant R in V1
 RAE
 R wave 7 mm ( 7
small squares) or
greater

18. 38 y M with CP

19. 67y F HD CP at 0400am

20. 65 y M with 1h CP

21. 45y M CP for 13 h vitals stable

22. 59 y F with 5h CP

23. 56 y M with 3h CP

24. 45 y M with 3h CP

25. 62 y F with 45 min CP

26. 59 y F 4h CP and BP 65/40

27. 63 y F 5h CP BP 64/32