This document provides descriptions of various ECG patterns and cardiac conditions: - It describes limb lead reversal showing a sine wave pattern typical of hyperkalemia. Calcium gluconate and other treatments are recommended. - Accelerated idioventricular rhythm is defined as having a rate between 50-100 bpm and being a type of slow ventricular tachycardia that does not typically require treatment. - Atrial flutter with a 4:1 conduction is described as typical or atypical, with atypical often occurring after surgeries. Atrial flutter can be cardioverted with the least amount of energy. - Several other conditions are briefly defined such as complete heart block, dextro

1. ECG QUIZ

3. LIMB LEAD REVERSAL
 LA and RA reversal

5. SINE WAVE PATTERN ECG
 Typical of Hyperkalemia
 Increased chances of asystole.
 Inj. Calcium gluconate IV to be given before control of
hyperkalemia.
 Insulin infusion ,injection lasix and B agonists have faster
action .

7. ACCELERATED
IDIOVENTRICULAR RHYTHM
 Accelerated because rate more than 50 and less than 100 bpm
 Also called as slow VT
 It is a reperfusion arrhythmia
 Need not be treated

9. ATRIAL FLUTTER with 4:1
conduction
 Typical
 Atypical
 Atypical mostly after surgeries
 Atrial flutter is the only arrhythmia which can be cardioverted with least
energy.

11. HYPOKALEMIA
 Typical U waves seen
 Camel hump sign.
 Prolonged repolarisation.

13. COMPLETE HEART BLOCK
 P and QRS complexes not related
 P waves marching through QRS

15. DEXTROCARDIA
 Similar to limb lead reversal LA and RA
 In precordial leads V1- V6 R wave regresses in height – the
differentiating point.

17. WELLEN’S SYNDROME
 Deeply inverted T waves in precordial leads
 Type B
 Indicates proxmial LAD tight stenosis
 ECG changes typically seen after relief of pain
 The rule – any patient with chest pain should be monitored
for 24 hrs preferably in ICU.

19. COMPLETE LBBB
 New onset LBBB – MI equivalent

21. WELLENS SYNDROME TYPE A
 Biphasic t waves seen in anterior precordial leads
 Not an STEMI as there are no reciprocal changes.

23. VENTRICULAR TACHYCARDIA

25. RVOT TACHYCARDIA
 LBBB morphology
 Typically benign
 In middle aged females
 Typically repsonds to adenosine and CCBs

27. BIDIRECTIONAL TACHYCARDIA
 Sine qua non of digoxin toxicity

29. POSTERIOR WALL MI
 Mirror images in V1- V3
 Usually associated with inferior and lateral wall MI’
 Isolated is rare occurrence
 Leads v7 –v9 to be taken

31. OSBORN J WAVE
 Seen in hypothermia

33. VENTRICULAR FIBRILLATION
 To be on nonsynchronous mode while giving shock

35. HYPOCALCEMIA
 Prolonged QT interval
 QT interval correlates with clinical symptoms

37. ACUTE EXTENSIVE ANTERIOR
WALL MYOCARDIAL
INFARCTION
 If not thrombolysed will go into QRBBB
 Tomb stone appearance of ST elevations
 Extensive AWMI – ST elevation from V1-V6 AND I AVL
 Indicates osteoproximal LAD occlusion
 High chances of VT and VT on reperfusion

39. MULTIFOCAL ATRIAL
TACHYCARDIA
 Usually seen in COPD patients
 They are refractory to usual drug treatment of SVT

41. PACEMAKER RHYTHM WITH
VENTRICULAR COUPLETS

43. ATRIAL FIBRILLATION WITH
SLOW VENTRICULAR RATE AND
MULTIFOCAL VPCS
SECODNARY TO DIGITOXICITY

45. COMPLETE RBBB
 Usually seen in males
 Smokers
 Common varinat in elderly people secondary to sclerosis of
conduction system

47. INFERIOR WALL STEMI WITH R
ON T PHENOMENON

49. SVT AVNRT
 ELECTRICAL ALTERNANS

51. QRBBB WITH LAFB

53. EPSILON WAVE
 ARVD

55. S1Q3T3 +RVH strain
 Massive pulmonary emoblism
 Seen in 15% ecgs
 Most common in sinus tachycardia

57. PULMONARY HYPERTENSION
ECG P PULMONALE

59. BIATRIAL ENLARGEMENT
RIGHT VENTRICULAR
HYPERTROPHY
SEVERE
MITRAL STENOSIS

61. LEFT VENTRICULAR
HYPERTROPHY
 Intraventricular conduction delay

63. ATRIAL FIBRILLATION WITH FVR
 Grand father of arrhythmias


65. PACEMAKER RHYTHM
 VVI mode

66. What is PARDEE’S sign?

67. ST segment elevation suggestive of
coronary artery obstruction

69. IWMI WITH AF

71. IW MI + RVMI
 Lead III > II
 V1 ST ELEVATION
 V4R typically shows Stelevation
 But they are trasient

73. EXTENSIVE ANTERIOR WALL
STEMI

75. HIGH LATERAL MI WITH PWMI

77. MI IN LBBB PATIENT
 SGARBOSSA CRITERIA

79. WILLEM EINTHOVEN

81. WILLIAM HARVEY

83. RENE LAENNAC
 Invented monoaural stethoscope

85. DISCOVERED DIGITALIS FROM
FOXGLOVE PURPUREA

87. JOSEPH LEOPOLD
AUENBRUGGER
 Invented percussion

89. SIR RONALD ROSS

91. SALK – POLIO VACCINE

93. NIKOLAI KOROTKOV
 KOROTKOFF IN english
 Auscultatory technique in blood pressure

94. Thank you