This document provides information about reading and interpreting electrocardiograms (EKGs), including the following key points: 1. When reading an EKG, one should examine the rhythm, rate, axis, signs of chamber enlargement, evidence of ischemia or injury, intervals between waves, and provide an overall conclusion. 2. A normal EKG has a regular rhythm with each P wave followed by a QRS complex. It also has normal amplitudes and durations for the various waves as well as normal axes determined by the leads. 3. Abnormalities that can be identified on EKG include signs of right or left atrial and ventricular enlargement as well as conditions like ischemia, injury, and arrhythm

1. All what you need to
know about EKG

5. Each lead looks at the heart

6. Normal waves and segments

7. Reading ECG
 Rhythm
 Rate
 Axis
 Chamber enlargement
 Ischemia ( ST, T, Q and LBBB)
 Intervals( PR, QRS, QT)
 Conclusion

8. Normal ECG
 Each P is followed by QRS
 P wave is + in I and AVL
 Rate is between 60-100
 P wave is less than 2.5 mm in height and
less than 0.11 mm in width
 PR interval 0.12-0.2 mm
 Normal QRS less 0.12 mm
 Normal QT is 0.42 mm
 Normal ST is isoelectric with PR or TP

9. Axis
both I and aVF +ve = normal axis
both I and aVF -ve = axis in the
Northwest Territory
lead I -ve and aVF +ve =
right axis deviation
lead I +ve and aVF -ve
lead II +ve = normal axis
lead II -ve = left axis deviation

10. Rate
 Or 300 divided by the
number of the large
squares divided
 Or number of the
QRSs multiplied by
10 (AF)

11. Right atrial enlargement
 P wave 3 mm ( 3
small squares) or
greater in height in
inferior leads
 P wave 1.5 mm (1.5
small squares ) or
greater in lead V1
 The P wave has a
sharp and peaked
appearance

12. Left atrial enlargement
 P wave notched and
exceeds 120 ms ( 3
small squares) in the
inferior leads
 The negative terminal
component of P wave
in V1 exceeds 40 ms
( 1 small squares )

13. Left ventricular hypertrophy
 S in lead V1 plus R in
either V5 or V6
greater than 35 mm
 R wave in lead aVL
greater than 11 mm

14. Right ventricular hypertrophy
 Right axis deviation
 Dominant R in V1
 RAE
 R wave 7 mm ( 7
small squares) or
greater

18. 38 y M with CP

19. 67y F HD CP at 0400am

20. 65 y M with 1h CP

21. 45y M CP for 13 h vitals stable

22. 59 y F with 5h CP

23. 56 y M with 3h CP

24. 45 y M with 3h CP

25. 62 y F with 45 min CP

26. 59 y F 4h CP and BP 65/40

27. 63 y F 5h CP BP 64/32