This document outlines an approach for interpreting electrocardiograms (ECGs). It discusses justifying ECG use based on symptoms or exam findings. A structured approach is presented: check quality, rate, rhythm, axis, P wave, PR interval, QRS duration/morphology, ST segment, T wave, QT interval. Abnormal findings are defined, such as ST depression indicating ischemia. The goal is to develop skills in systematic ECG interpretation and identifying common abnormalities.
6. Why perform an ECG? It’s part of the admission bundle
Indicated by the patient’s symptoms
- symptoms of IHD/MI
- symptoms associated with dysrhythmias
Indicated by the patient’s examination findings
- cardiac murmur
7. ECG interpretationQuality of ECG?
Rate
Rhythm
Axis
P wave
PR interval
QRS duration
QRS morphology
Abnormal Q waves
ST segment
T wave
QT interval
8. Quality of the ECG
Patient name
Date of the ECG
Is there any interference?
Is there electrical activity from all 12
leads?
Calibration:
- speed = 25mm/second
- height = 1cm/mV
23. PR interval Start of P wave to start of QRS complex
Normal = 0.12 - 0.2 seconds (3-5 small squares)
Decreased = can indicate an accessory pathway
Increased = indicates AV block (1st
/2nd
/3rd
)
24. ECG interpretationQuality of ECG?
Rate
Rhythm
Axis
P wave
PR interval
QRS duration
QRS morphology
Abnormal Q waves
ST segment
T wave
QT interval