ECG made easy, Lecture notes of Cardiology

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ECG made easy

1

• Presented by:
• Dr Randall Hendriks, Interventional Cardiologist – Western Australia

Reading an ECG

• The ECG does not have to be intimidating
• Establish a consistent approach to interpreting ECGs
• Do not rely on machine reads
• Interpret the ECG in the context of the clinical history

Lead Placement

aVF

All Limb Leads

Components of a normal ECG

• P wave - atrial depolarisation
• PR interval - AV node + His-P
• QRS - ventricular depolarisation
• T wave - ventricular repolarisation

ECG interpretation

• Rate

• Rhythm
• Axis
• P wave
• Intervals
  • PR interval
  • QRS duration
  • QT interval
• Q waves
• R wave transition
• ST segments
• T waves (and others)

Rate

• HR of 60-100 per minute is normal
• HR > 100 = tachycardia
• HR < 60 = bradycardia

Single Lead ECG: Provides

Heart rate: normal 60 – 100 Remember: Pulse rate may not equal heart rate

Rhythm

• Sinus
  • Originating from SA node
  • P wave before every QRS
  • P wave in same direction as QRS

ECG interpretation

• Rate
• Rhythm

• Axis

• P wave
• Intervals
  • PR interval
  • QRS duration
  • QT interval
• Q waves
• R wave transition
• ST segments
• T waves (and others)

Left axis deviation: check lead II

Right axis deviation: check lead I

P wave

RA enlargement