A single Q wave is not a cause for concern – look for Q waves in an entire territory (e.g. anterior/inferior) for evidence of previous myocardial infarction. An example of a pathological Q wave R and S waves If the R and S waves are of equal size, it means depolarisation is travelling at exactly 90° to that lead. Poor progression (i.e. S > R through to leads V5 and V6) can be a sign of previous MI but can also occur in very large people due to poor lead position. An example of poor R wave progression due to a previous anteroseptal MI. 1 J point segment The lead with the most positive deflection is most aligned with the direction the heart’s electrical activity is travelling. Observe the distribution of the T wave inversion (e.g. anterior/lateral/posterior leads). You must take this ECG finding and apply it in the clinical context of your patient. Inverted T wave Biphasic T waves

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An ECG lead is a graphical representation of the heart’s electrical activity calculated by analysing data from several ECG electrodes. Chest leads Each lead’s ECG recording is slightly different in shape. This is because each lead is recording the heart’s electrical activity from a different direction (a.k.a viewpoint). Count the number of complexes on the rhythm strip (each rhythm strip is typically 10 seconds long). RAD is commonly associated with conditions such as pulmonary hypertension, as they cause right ventricular hypertrophy. RAD can, however, be a normal finding in very tall individuals. Right Axis Deviation Left axis deviation Tall complexes imply ventricular hypertrophy (although can be due to body habitus e.g. tall slim people). There are numerous algorithms for measuring LVH, such as the Sokolow-Lyon index or the Cornell index.For over forty years The ECG Made Easy has been regarded as the best introductory guide to the ECG, with sales of over half a million copies as well as being translated into more than a dozen languages. Hailed by the British Medical Journal as a "med You may also be interested in our ECG interpretation OSCE stations available as part of our collection of 800+ ready-made OSCE stations. The deflection height represents the amount of electrical activity flowing in that direction (i.e. the higher the deflection, the greater the amount of electrical activity flowing towards the lead). Typical ECG findings include the presence of P waves and QRS complexes that have no association with each other, due to the atria and ventricles functioning independently. The T waves are also raised (in contrast to a STEMI, where the T wave remains the same size and the ST segment is raised).

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The ST segment is an isoelectric line representing the time between depolarisation and repolarisation of the ventricles (i.e. ventricular contraction). T wave It represents the time taken for the ventricles to depolarise and then repolarise. The components of an ECGIt represents the time for electrical activity to move between the atria and the ventricles. QRS complex Amjid Rehman has created an innovative, interactive online application to assist in honing and refining your ECG interpretation skills.

How to Read an ECG | ECG Interpretation | EKG | Geeky Medics How to Read an ECG | ECG Interpretation | EKG | Geeky Medics

The PR interval should be between 120-200 ms (3-5 small squares). Prolonged PR interval (>0.2 seconds) Left axis deviation (LAD) involves the direction of depolarisation being distorted to the left (between -30° and -90°). This results in the deflection of lead III becoming negative (this is only considered significant if the deflection of lead II also becomes negative). Conduction abnormalities usually cause left axis deviation. Left Axis Deviation (LAD) Elsevier is a leading publisher of health science books and journals, helping to advance medicine by delivering superior education, reference information and decision support tools to doctors, nurses, health practitioners and students. With titles available across a variety of media, we are able to supply the information you need in the most convenient format.

A pathological Q wave is > 25% the size of the R wave that follows it or > 2mm in height and > 40ms in width.

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Typically, the J point is raised with widespread ST elevation in multiple territories making ischaemia less likely.

You might also be interested in our OSCE Flashcard Collection which contains over 3000 flashcards that cover clinical examination, procedures, communication skills and data interpretation. how many times have you revised ‘ how to interpret an ECG‘? For me, it’s at least annually for the last 20 years, and still, I forget! Amjid Rehman Narrow-complex escape rhythms (QRS complexes of <0.12 seconds duration) originate above the bifurcation of the bundle of His.