ECG is one of the most important matters the medical students, residents and even specialists care about, and need to master it. These slides demonstrate the basics of ECG, basic abnormalities that can be seen while reading ECG in a simple and understandable language. It takes you from the beginning to the maximum level of how to correctly read an ECG. While under

1. Ninth step isUwave
• Not a common finding.
• The U wave is a >0.5mm deflection after the Twave best seen in V2 or V3.
• These become larger the slower the bradycardia – classically U waves are seen in
various electrolyte imbalances or hypothermia, or antiarrhythmic therapy (such as digoxin,
procainamide or amiodarone).

2. Chamber enlargement
• Tricuspid stenosis or Pulmonary HTN (peaked P )
• Mitral stenosis ( broad bifid P)

3. Severe Right ventricular Hypertrophy
• Dominant R waves in lead V1
• Deep S waves in lead V
• Inverted T in II,III,VF, V1-3
• Flat T in V4-5

4. Left ventricular Hypertrophy
• Tall R in V5-6 and Deep S in V1-2
• Inverted T in I,VL,V5-6

5. Electrolytes Disturbance
• A low K+ level : T wave flattening, U wave
• A high K+ level : peaked T waves ,disappearance of the ST segment.
The effects of abnormal magnesium levels are similar.
• A low plasma Ca+2 level causes prolongation of the QT interval, and a
high plasma calcium level shortens it.

6. Hypokalemia

7. Hyperkalemia

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