Ecg osce for examination

1. OSCE ECG

2. ECG - 1
• Interpret the ECG below and answer the following questions
1. What is the rate?
2. Rhythm regular/irregular?
3. What is the diagnosis ?
4. Name the ECG finding that lead to your diagnosis.

3. ECG - 1
1. 75
2. Regular
3. Atrial flutter
4. Saw tooth appearance , Narrow QRS

4. • Unresponsive, pulseless patient brought to the casualty
1. Interpret the ECG
2. What do you check before confirming the diagnosis
3. Is the rhythm shockable or non shockable?
4. What is the drug of choice in the management ?
ECG - 2

5. ECG 2
1. Asystole
2. Check the leads, augment the ECG
3. Non-shockable
4. adrenaline

6. ECG- 3
60 year old patient with Mitral Stenosis admitted in ICU patient is
hemodynamically unstable and ECHO ruled out clot in chambers , patients ECG
is as follows
1. What is the diagnosis ?
2. Name two ECG findings that lead to your diagnosis.
3. What is further line of management?

7. ECG 3
1. Atrial Fibrillation
2. Absent P wave, irregularly irregular RR interval
3. Cardioversion

8. • Unresponsive, pulseless patient brought to the casualty. ECG taken is as
following
1. Interpret the ECG
2. Is the rhythm shock able or non shock able?
3. What are the drugs administered with the doses in the management ?
ECG-4

9. ECG - 4
• Ventricular tachycardia
• Shockable rhythm
• After 2nd shock administer Epinephrine 1 mg ,
• After 3rd shock Amiodarone 300mg first dose /Lignocaine 1-
1.5mg/kg
• After 5th schock 150mg 2nd
dose

10. • Interpret the ECG below and answer the following questions
1. What is the rate?
2. Rhythm regular/irregular?
3. QRS narrow or wide ?
4. P to QRS ratio?
5. What is the diagnosis ?
ECG 5

11. ECG 5
1. 120/min
2. Regular
3. Narrow
4. 1:1
5. Sinus tachycardia

12. 60 year old patient hemodynamically stable ,undergoing laparotomy
for intestinal obstruction presents with following ECG in the monitor
intraoperativly
1. What is the diagnosis ?
2. Name two ECG findings that lead to your diagnosis.
3. What is the further line of management?
ECG 6

13. ECG - 6
1. Supraventricular tachycardia
2. Absent P wave, Narrow QRS, Rate more than 150
3. First step:vagal maneuver
4. Second step:Adenosine 6mg , second dose 12 mg
5. Beta blocker can be given

14. Unresponsive, pulseless patient brought to the casualty
1. Interpret the ECG
2. Is the rhythm shockable or non shockable?
3. What is the drugs of choice with doses in the management ?
ECG 7

15. ECG 7
• Ventricular fibrillation
• Shockable rhythm
• After 2nd shock administer Epinephrine 1 mg ,
• After 3rd shock Amiodarone 300mg first dose /Lignocaine 1-
1.5mg/kg
• After 5th shock 150mg 2nd
dose

16. • Interpret the ECG below and answer the following questions
1. What is the rate?
2. What is the diagnosis ?
3. Name one findings to come to the diagnosis.
ECG 8

17. ECG - 8
1. 75 /min
2. 1st
degree heart block
3. Prolonged PR interval

18. • Interpret the ECG below and answer the following questions
1. What is the rate?
2. What is the diagnosis ?
3. Name two findings to come to the diagnosis.
ECG - 9

19. ECG 9
1. 50/min
2. 2nd
degree heart block , Mobitz type 1
3. Wenckebach phenomenon( progressively increasing PR),
bradycardia, irregular RR interval

20. • Interpret the ECG below and answer the following questions
1. What is the rate?
2. What is the diagnosis ?
3. Name two findings to come to the diagnosis.
ECG 10

21. ECG 10
1. 60/min
2. 2nd
degree heart block , Mobitz type II
3. Bradycardia , PR interval is constant, irregular RR interval ,2:1
conduction

22. Interpret the ECG below and answer the following questions
1. What is the rate?
2. Rhythm - regular/irregular?
3. Calculate PR interval ?
4. What is the diagnosis ?
ECG - 11

23. ECG 11
1. 75/min
2. Regular
3. 120ms
4. Normal Sinus Rhythm

24. Interpret the ECG below and answer the following questions
1. What is the rate?
2. Name two findings to come to the diagnosis.
3. What is the diagnosis ?
ECG - 12

25. ECG 12
1. 38/min
2. Bradycardia , wide QRS, P-QRS dissociation, Regular RR interval
3. Third degree heart block

26. • Interpret the ECG below and answer the following questions
1. What is the rate? (1 mark)
2. Comment on P wave characteristics?
3. What is the interpretation ?
4. Which heart chamber enlargement leads to this characteristic?
ECG 13

27. ECG - 13
• 150/min
• Tall and peaked P wave
• P Pulmonale
• Right atrial

28. • Interpret the ECG below and answer the following questions
1. What is the rate?
2. Comment on P wave characteristics?
3. What is the interpretation ?
4. Which heart chamber enlargement leads to this characteristic?
ECG - 14

29. ECG - 14
1. 75/min
2. Broad , double peaked P wave
3. P Mitrale
4. Left Atrium

30. ECG - 15
• Interpret the ECG below and answer the following questions
1. What is the rate?
2. Rhythm regular/irregular?
3. What is the diagnosis ?
4. Name the ECG finding that lead to your diagnosis.

31. ECG 15

32. ECG 15
1. 50 per minute
2. Regular
3. Left ventricular Hypertrophy with strain
4. Rwave in V5 and V6 greater 25 mm, Rwave in V5 and V6 +S wave
in V1V2 greater than 35

33. ECG - 16
• Interpret the ECG below and answer the following questions
1. What is the rate?
2. Rhythm regular/irregular?
3. What is the diagnosis ?
4. Name the ECG finding that lead to your diagnosis.

34. ECG 16

35. ECG - 16
1. 100 per minute
2. Regular
3. Right ventricular hypertrophy
4. Dominant R wave in V1 (> 7mm tall or R/S ratio > 1).Dominant
S wave in V5 or V6 (> 7mm deep or R/S ratio < 1).

36. ECG 17
A 50-year-old man is seen in the emergency department with severe
central chest pain which has been present for 18 h. What does this
ECG show and what would you do?

37. ECG 17
• The ECG shows:
• Sinus rhythm
• Normal axis
• Q waves in leads V2-V4
• Raised ST segments in leads V2-V4
• Inverted T waves in leads I, VL, V2-V6
Clinical interpretation
This is a classic acute anterior myocardial infarction.

38. ECG 18

39. ECG 18
• Right axis deviation (RAD)
• Positive QRS complexes (with upright P and T waves) in aVR
• Lead I: inversion of all complexes, aka ‘global negativity’ (inverted
P wave, negative QRS, inverted T wave)
• Absent R-wave progression in the chest leads (dominant S waves
throughout)
INTERPRETATION:- DEXTROCARDIA

40. ECG 19

41. ECG 19
• ISOLATED VPC/PVC