Approach to ECGs

Check

 - Age, gender, name

 - 25mm/s; 10mm/mV

 - 1mm = 40ms; 0.1 mV

Rate

 - 300 / big squares - RR only

 - #QRS in 10s

 - 2 dots = 3s; #QRS in 6s x 10

Rhythm

(1) Pfor every QRS and vv

(2) P+ve in l, II

(3) 60-100 bpm

 - Axis - QRS +ve in I, II

 - LAD: Inf Ml, WPW, LVH, LBBB, LAFB

 - RAD: AntLat MI, WPW, RVH, RBBB, dextrocardia, normal LPFB, dextrocardia, normal

Intervals

 - PR = 120-200ms (3-5 small boxes)

 - HiPR: AV block

 - LoPR: WPW, ectopic atrial pacemaker

 - QRS = < 100-120ms (<2.5-3 small boxes)

 - WideQRS: RBBB (V1/V2 rsr', lat leads slurred S), LBBB (V5/V6 rs, qs; lat leads rsr'), V-pacemaker, ↑K, ICD/pacer 

 - QTc < 1/2 RR or M<420ms, F<440ms, no safe #, but >500 DANGER

 - Short QT <300-360 ms: ↑ca

 - Long QT: "antis and hypos"-ABx, antipsychotics, antidepressants, TCA, antihistamines, antiarhythmics, hypo K, hypo Mg, congenital, MI, high ICP

Hypertrophy



- Dr. Michael Wong @mchlwng



#Approach #ECG #EKG #diagnosis #electrocardiogram #cardiology #interpretation