The document provides descriptions of various cardiac rhythms, conduction abnormalities, myocardial infarctions and other cardiac conditions as assessed by electrocardiogram findings. Key items summarized include descriptions of flutter, fibrillation, supraventricular and atrial tachycardias, bundle branch and fascicular blocks, atrioventricular blocks, preexcitation syndromes, myocardial infarction in various territories, athlete's heart, electrolyte abnormalities, drug effects and various cardiac pathologies.

1. FLUTTER =
II P – V1 P RHYTHM REGULAR SAW TOOTHED – BLOCK 2:1 3:1 4:1 etc –
RA HTfy : P DURATION = NORMAL – P MAYBE RIGHT AXIS – ATRIAL BPM 250 – 350 – VENTICULAR BPM ½ 1/3 ¼ etc – CAROTID MASSAGE INCREASES
BLOCK
P 1ST POSRTION INCREASE AMPLITUDE
LA HTfy : P DURATION = INCREASED – P 2ND PORTION INCREASED –
P NO AXIS
RV HTfy : RIGHT AXIS – V1 R – V6 S FIBRILATION :
LV HTfy IREGULAR – ATRIAL BPM 350 – 500 –
PRECORDIAL CRITERIA
VENTRICULAR BPM VARIABLE –
V5 OR V6 R + V1 OR V2 S > 35mm CAROTID MASSAGE MAY SLOW VENTRICULAR RATE
V5 R > 26 mm – V6 R > 18 mm – V6 R > V5 R
LIMB CRITERIA
VL R > 13mm – VF R > 21 mm – I R > 14 mm –
I R + III S > 25 mm
MAT = MULTIFOCAL ATRIAL TACHYCARDIA
REPOLARIZATION ABNORMALITIES
IREGULAR – P 3 – MORE DIFFERENT MORPHOLOGIES –
ST ASYMMETRIC DIPRESSION – T INVERSION : IN LEADS WITH TALL T = SIGNIFICANT HYPERTROPHY, VENTRICULAR DILATON, FAILURE
BPM 100 – 200 OR LESS – CAROTIDMASSAGE NO EFFECT
PAT = PAROXYSMAL ATRIAL TACHYCARDIA
PSVT = PAROXISMIC SUPRAVENTRICULAR TACHYCARDIA
REGULAR – BPM 100 – 200 – C
RHYTHM REGULAR – P IF VISIBLE, RETROGRADE – BPM 150 – 200 – CAROTID MASSAGE
SLOWS OR TERMINATES AROTID MASAGE NO EFFECT OR ONLY MILD SLOWING

2. LEFT ANTERIOR HEMIBLOCK = LA HEMI-
QRS NORMAL DURATION – ST,T NO CHANGES – LEFT AXIS –
NO OTHER CAUSES OF LEFT AXIS
LEFT POSTERIOR HEMIBLOCK = LP HEMI-
QRS NORMAL DURATION – ST, T NO CHANGES – RIGHT AXIS –
NO OTHER CAUSES OF RIGHT AXIS
BIFASCICULAR BLOCK
RBBB + LA HEMI- = QRS >0.12 – V1,V2 RSR’ – LEFT AXIS
RBBB + LP HEMI- = QRS >0.12 – V1,V2 RSR’ – RIGHT AXIS
AV BLOCKS
ST PREEXCITATION
1 DEGREE = PR > 0.2 SEC – P:QRS
ND
WPW = PR < 0.12 SEC – QRS > 0.12=WIDE – DELTA WAVES
2 DEGREE = PR > 0.2 SEC – NOT ALWAYS P:QRS
LGL = PR < 0.12 – QRS NORMAL – NO DELTA WAVES
MOBITZ I =WENCKENBACH = PR PROGRESSIVE PROLONGATION UNTIL QRS IS DROPPED
COMMON ACOMPANING ARRYTHMIAS =
MOBITZ II = PR NO PROLONGATION - QRS ARE DROPPED
RD PSVT WITH NARROW QRS – AtFibril  VentFibril
3 DEGREE = COMPLETE BLOCK = AV DISSOCIATION = INDEPENDED Pacemakers
MI = EXAM – ENZYMES – ECG
T PEAK  T INVERSION -- ST ELEVATION -- Q WAVES
Q WAVE CRITERIA
>0.04 SEC – Q DEPTH => 1/3 R IN THE SAME COMPLEX
MI NONQ CRITERIA =
RIGHT BUNDLE BRANCH BLOCK = RBBB T INVERSION – ST DEPRESSION > 48 HOURS
QRS > 0.12 – V1,V2 RSR’ = RABIT EAR – ST DEPRESSION – INFERIOR MI =
T INVERSION – V5,V6,I,VL RECIPROCAL CHANGES II,III,VF – RIGHT CORONARY OR DESCENDING BRANCH –
LBBB ANTERIOR, LEFT LATERAL LEADS RECIPROCALS
QRS > 0.12 SEC – V5,V6,I,VL R BROAD OR NOTCHED – LATERAL MI =
V5,V6,I,VL – OFTEN = LEFT CIRCUMFLEX OCLUSSION –
ST DEPRESSION – T INVERSION – V1,V2 RECIPROCALS –
INFERIOR RECIPROCALS
LEFT AXIS MAYBE
ANTERIOR MI = V1,…,V6 – OFTEN = LEFT ANTERIOR DESCENDING – INFERIOR RECIPROCALS

3. POSTERIOR MI = V1 RECIPROCALS = ST DEPRESSION T TALL = OFTEN = RIGHT CORONARY ATHLETE HEART
OCCLUSION
SINUS BRADYCARDIA – ST,T NONSPESIFIC CHANGES –
ST ELEVATION = MI – PRINZMETAL ANGINA
LV HTfy -- RV HTfy – RBBB INCOMPLETE –
ST DEPRESSION = NONQ MI – TYPICAL EXERTIONAL ANGINA – POSSITIVE
AV BLOCK 1ST DEGREE – OR WENCKENBACH AV BLOCK – SUPRAVENTRICULAR
STRESS TEST
TACHYCARDIA OCCASIONAL
HYPERKALEMIA
T PEAK, PR PROLONGATION, P FLAT,
QRS WIDE  QRS + T MERGE TO SINE WAVE,  Vent Fibril
HYPOKALEMIA =
ST DEPRESSION, T FLAT, U WAVES
HYPOCALCEMIA = QT PROLONGATION
HYPERCALCEMIA = QT SHORT
HYPOTHERMIA = OSBORNE WAVE
DIGITALIS
THERAPEUTIC LEVELS = ST,T CHANGES IN LEADS WITH TALL R
TOXI LEVELS = TACHYARRYTHMIAS, CONDUCTION BLOCKS, PAT + BLOCK = MOST
COMMON
SOTALOL, QUINIDINE, PROCAINAMIDE, AMIODARONE, TRICYCLICS,
QUINOLONES, PHENOTHIAZINES, ERYTHROMYCIN, SOME ANTISTAMINES,
ANTIFUNGALS = QT PROLONGATION – U WAVE
PERICARDITIS =
ST,T DIFFUSE CHANGES – LOW VOLTAGE IF LARGE EFFUSION
HOCM = LEFT AXIS – Q SEPTAL LEADS
MYOCADITIS = CONDUCTION BLOCKS
COPD =
LOW VOLTAGE – RIGHT AXIS – R POOR PROGRESSION –
RV HTfY , P PULMONALE – REPOLIRIZATION ABNORMALITIES
ACUTE PULMONARY EMBOLISM =
RBBB – I S – III Q – RV HTfy –
ARRYTMIA = COMMON = SINUS TAVHYCARDIA OR ATRIAL FIBRILATION
CNS DISEASE =
T DIFFUSE INVERSION = WIDE AND DEEP -- U WAVES