12 Lead EKG Interpretation

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  • Axis refers to the direction of the depolarization, which spreads throughout the heart to stimulate the myocardium to contract. Depolarization means an advancing wave of Na positive ions! Avis deviation is frontal plane, Axis rotation is horizontal plane
  • Bi phasic p wave looks like a letter M
  • Biphasic P wave
  • ST elevation of above 2 mm at least from baseline
  • Inferior Wall MI: check Q waves II, III, AVF…Normal axis deviation (check I and AVF), normal axis rotation (checKIsoelectric QRS V1 to V6)
  • Postero-Lateral Wall MI check Q waves in I, AVL, V5, V6 plus large R wave in V1 V2 V3
  • Postero-Inferior Wall MI with RBBB: Large R wave in V1 V2 V3 V4; Q waves in II, III, AVF; V1 Rabbit ears RBBB
  • Right Ventricular Hypertrophy: Large R wave in V1 then R wave becomes smaller and smaller from V2 V3 V4
  • WPW Rhythm
  • Wandering Atrial Pacemaker
  • Atrial Pacemaker
  • 12 Lead EKG Interpretation

    1. 1. 12 Lead EKG Interpretation<br />Reading with Confidence!!!!!<br />Presented by: Herbert Hanter<br />
    2. 2. Five Simple Steps!<br />1. Rate? 300, 150, 100, 75, 60<br />2. Rhythm? P waves, Intervals, QRS<br />3. Axis Deviation? Left or Right? Check Lead I and AVF<br /> Axis Rotation check Chest Leads V1 to V6<br />4. Hypertrophy? Atrial Or Ventricular Hypertrophy?<br />5. Infarction? Q waves? Location?<br />
    3. 3. When Interpreting a 12 lead EKG<br />Forget about AVR!!!!<br />
    4. 4. Location of Infarction and Enlargement<br />Lateral Infarction- Q waves in I and AVL, V5 and V6<br />Inferior Infarction- Q waves in II, III, and AVF<br />Anterior Infarction- Q waves in V3 V4 plus ST elevation<br />Posterior Infarction- Large R wave In V1 V2 V3 plus ST depression, plus Q wave in V6<br />Septal Infarction- Q waves V1 V2<br />Atrial Enlargement- Check P wave in V1<br />Right Ventricular Enlargement- large R wave and small S wave in V1 then R wave becomes smaller and smaller from V2, V3, and V4<br />
    5. 5. Continuation<br />Left Ventricular Hypertrophy- tall R wave in V5 and deep S wave in V1 (add mm V1 and V5..if total 35 mm there is LVH!)<br />
    6. 6. Right Axis Deviation<br />
    7. 7. Left Axis Deviation<br />
    8. 8. Right Atrial Hypertrophy<br />
    9. 9. Left Atrial Hypertrophy<br />
    10. 10. Myocardial Infarction<br />ST Wave Elevation<br />
    11. 11. Review of Common Rhythms<br />1. Normal Sinus Rhythm<br />2. Sinus Bradycardia<br />
    12. 12. Common Rhythms<br />3. Sinus Tachycardia<br />4. Supraventricular Tachycardia<br />
    13. 13. Common Rhythms<br />5. Atrial Fibrillation<br />6. Atrial Flutter<br />
    14. 14. Common Rhythms<br />7. First Degree AV Block<br />8. 2nd Degree AV Block Type 1 (Wenckebach)<br />
    15. 15. Common Rhythms<br />9. 2nd Degree AV Block Type 2<br />10. 3rd Degree AV Block<br />
    16. 16. Common Rhythms<br />11. Bundle Branch Block<br />
    17. 17. Common Rhythms<br />12. Premature Ventricular Complexes<br />Single <br />Multiple<br />
    18. 18. Common Rhythms<br />13. Junctional Rhythms<br />Accelerated Junctional Rhythm<br />
    19. 19. Common Rhythms<br />14. Ventricular Tachycardia<br />15. Ventricular Fibrillation<br />
    20. 20. Common Rhythms<br />16. Torsades de Pointes<br />
    21. 21. Common Rhythms<br />17. Asystole<br />
    22. 22. Practice EKG Interpretation<br />
    23. 23. Practice EKG Interpretation<br />
    24. 24. Practice EKG Interpretation<br />
    25. 25. Practice EKG Interpretation<br />
    26. 26. Practice EKG Interpretation<br />
    27. 27. Practice EKG Interpretation<br />
    28. 28. Practice EKG Interpretation<br />
    29. 29. Practice EKG Interpretation<br />
    30. 30. Practice EKG Interpretation<br />

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