Stepwise interpretation of ECG - #3 ID659
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A 68-year-old man presented to the emergency department after an accidental fall. An ECG was performed which showed sinus rhythm at a rate of 100 bpm with frequent premature ventricular complexes. The PR interval, QRS duration, axis, and ST segment and T waves were all normal, with no evidence of chamber enlargement, conduction abnormalities, or myocardial infarction. The final diagnosis was sinus rhythm with frequent premature ventricular complexes, with an otherwise normal ECG.
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Stepwise interpretation of ECG - #3 ID659
A 68-year-old man presented to the emergency department after an accidental fall. An ECG was performed which showed sinus rhythm at a rate of 100 bpm with frequent premature ventricular complexes. The PR interval and QRS complexes were normal, indicating no signs of conduction abnormalities. There was also no evidence of chamber enlargement, myocardial infarction, or ischemia. The final diagnosis was sinus rhythm with frequent premature ventricular complexes, but an otherwise normal ECG.
ECG PART 1
This document provides an overview of ECG rhythm interpretation and covers the following key points:
- The objectives are to recognize normal sinus rhythm, 13 common arrhythmias, and acute myocardial infarction on ECGs.
- The learning modules cover ECG basics, rhythm analysis, normal sinus rhythm, arrhythmias, myocardial infarction, and advanced 12-lead interpretation.
- It explains normal impulse conduction through the heart and how this relates to the PQRST waves on an ECG strip.
ECG PART 4
This document provides an overview of an ECG rhythm interpretation course, which aims to teach students to recognize normal sinus rhythm, 13 common arrhythmias, and myocardial infarctions. The learning modules cover ECG basics, rhythm analysis, sinus rhythms, premature beats, arrhythmias, and myocardial infarction diagnosis. Specific rhythms discussed include sinus bradycardia, sinus tachycardia, premature atrial contractions, and premature ventricular contractions. The key deviations and etiologies of each rhythm are explained.
ECG PART 8
This document outlines an ECG rhythm interpretation course, including the following key objectives: recognizing normal sinus rhythm, common arrhythmias, and myocardial infarctions on ECGs. It covers ECG basics, analyzing rhythms, identifying normal sinus rhythm, arrhythmias, myocardial infarctions, and advanced 12-lead interpretations. Specific topics include ST elevation and non-ST elevation MIs, left ventricular hypertrophy, and bundle branch blocks.
Shadechapter11.ppt [read only]
This document defines and describes various types of ventricular dysrhythmias. It notes that ventricular dysrhythmias occur when the atria, AV junction, or both cannot initiate an electrical impulse or there is enhanced excitability of the ventricular myocardium. Key features include wide, bizarre QRS complexes with T waves in the opposite direction of R waves and no P waves. Specific dysrhythmias covered include premature ventricular contractions, ventricular escape rhythms, ventricular tachycardia, ventricular fibrillation, asystole, idioventricular rhythm, and pulseless electrical activity. Characteristics and identifying features of each dysrhythmia are provided.
ECG PART 7
This document provides information on interpreting electrocardiograms (ECGs) to diagnose acute myocardial infarction (AMI). It discusses that an AMI is diagnosed using a 12-lead ECG rather than just a rhythm strip. The 12-lead ECG views the heart from 12 angles and can identify elevation in specific leads to determine if the AMI is located in the anterior, lateral, or inferior wall of the heart. Anterior wall AMIs present with ST elevation in leads V1-V4, lateral wall AMIs in leads I, aVL, and V5-V6, and inferior wall AMIs in leads II, III, and aVF. The document uses examples of 12-lead ECGs to demonstrate identifying
Shadechapter05.ppt [read only]
The third step of analyzing an ECG is examining the P waves. P waves can look different if they originate from outside the sinoatrial node or if there is damage to the atria. P' waves from other sites like the atrioventricular junction will have a different morphology. Rapid atrial rates may cause flutter waves or fibrillatory waves instead of P waves. More P waves than QRS complexes indicates block above the ventricles.
Shadechapter10.ppt [read only]
This document discusses different types of junctional dysrhythmias:
- Junctional rhythms originate in the atrioventricular (AV) junction and can cause inverted or absent P waves.
- A premature junctional complex is a single early impulse from the AV junction.
- A junctional escape rhythm arises from the AV junction at a rate of 40-60 beats per minute.
- An accelerated junctional rhythm has a rate of 60-100 beats per minute from the AV junction.
- Junctional tachycardia is a fast rhythm of 100-180 beats per minute from the bundle of His.
Recommended
Stepwise interpretation of ECG - #3 ID659
A 68-year-old man presented to the emergency department after an accidental fall. An ECG was performed which showed sinus rhythm at a rate of 100 bpm with frequent premature ventricular complexes. The PR interval and QRS complexes were normal, indicating no signs of conduction abnormalities. There was also no evidence of chamber enlargement, myocardial infarction, or ischemia. The final diagnosis was sinus rhythm with frequent premature ventricular complexes, but an otherwise normal ECG.
ECG PART 1
This document provides an overview of ECG rhythm interpretation and covers the following key points:
- The objectives are to recognize normal sinus rhythm, 13 common arrhythmias, and acute myocardial infarction on ECGs.
- The learning modules cover ECG basics, rhythm analysis, normal sinus rhythm, arrhythmias, myocardial infarction, and advanced 12-lead interpretation.
- It explains normal impulse conduction through the heart and how this relates to the PQRST waves on an ECG strip.
ECG PART 4
This document provides an overview of an ECG rhythm interpretation course, which aims to teach students to recognize normal sinus rhythm, 13 common arrhythmias, and myocardial infarctions. The learning modules cover ECG basics, rhythm analysis, sinus rhythms, premature beats, arrhythmias, and myocardial infarction diagnosis. Specific rhythms discussed include sinus bradycardia, sinus tachycardia, premature atrial contractions, and premature ventricular contractions. The key deviations and etiologies of each rhythm are explained.
ECG PART 8
This document outlines an ECG rhythm interpretation course, including the following key objectives: recognizing normal sinus rhythm, common arrhythmias, and myocardial infarctions on ECGs. It covers ECG basics, analyzing rhythms, identifying normal sinus rhythm, arrhythmias, myocardial infarctions, and advanced 12-lead interpretations. Specific topics include ST elevation and non-ST elevation MIs, left ventricular hypertrophy, and bundle branch blocks.
Shadechapter11.ppt [read only]
This document defines and describes various types of ventricular dysrhythmias. It notes that ventricular dysrhythmias occur when the atria, AV junction, or both cannot initiate an electrical impulse or there is enhanced excitability of the ventricular myocardium. Key features include wide, bizarre QRS complexes with T waves in the opposite direction of R waves and no P waves. Specific dysrhythmias covered include premature ventricular contractions, ventricular escape rhythms, ventricular tachycardia, ventricular fibrillation, asystole, idioventricular rhythm, and pulseless electrical activity. Characteristics and identifying features of each dysrhythmia are provided.
ECG PART 7
This document provides information on interpreting electrocardiograms (ECGs) to diagnose acute myocardial infarction (AMI). It discusses that an AMI is diagnosed using a 12-lead ECG rather than just a rhythm strip. The 12-lead ECG views the heart from 12 angles and can identify elevation in specific leads to determine if the AMI is located in the anterior, lateral, or inferior wall of the heart. Anterior wall AMIs present with ST elevation in leads V1-V4, lateral wall AMIs in leads I, aVL, and V5-V6, and inferior wall AMIs in leads II, III, and aVF. The document uses examples of 12-lead ECGs to demonstrate identifying
Shadechapter05.ppt [read only]
The third step of analyzing an ECG is examining the P waves. P waves can look different if they originate from outside the sinoatrial node or if there is damage to the atria. P' waves from other sites like the atrioventricular junction will have a different morphology. Rapid atrial rates may cause flutter waves or fibrillatory waves instead of P waves. More P waves than QRS complexes indicates block above the ventricles.
Shadechapter10.ppt [read only]
This document discusses different types of junctional dysrhythmias:
- Junctional rhythms originate in the atrioventricular (AV) junction and can cause inverted or absent P waves.
- A premature junctional complex is a single early impulse from the AV junction.
- A junctional escape rhythm arises from the AV junction at a rate of 40-60 beats per minute.
- An accelerated junctional rhythm has a rate of 60-100 beats per minute from the AV junction.
- Junctional tachycardia is a fast rhythm of 100-180 beats per minute from the bundle of His.
Shadechapter12.ppt [read only]
This document discusses different types of atrioventricular (AV) heart blocks. It defines heart blocks as delays or interruptions in conduction between the atria and ventricles. It then proceeds to describe the characteristics of 1st-degree AV block, 2nd-degree AV block types I and II, and 3rd-degree AV block. Specifically, it notes that 2nd-degree type I block shows a regularly irregular rhythm with a progressively lengthening PR interval, while 2nd-degree type II block maintains a constant PR interval with more P waves than QRS complexes. 3rd-degree block results in independent atrial and ventricular rhythms that can decrease cardiac output if the ventricular rate is too slow.
Shadechapter09.ppt [read only]
Atrial dysrhythmias originate outside the SA node and are caused by three mechanisms: increased automaticity, triggered activity, and reentry. Key characteristics include abnormal P waves and P-R intervals with normal QRS complexes. Wandering atrial pacemaker produces changing P waves as the pacemaker site shifts. Premature atrial complexes originate outside the SA node and cause rhythm irregularity with different P wave morphologies. Atrial tachycardia and multifocal atrial tachycardia involve rapid atrial rates while supraventricular tachycardia cannot identify a specific origin. Atrial flutter shows sawtooth waves at 250-350 bpm and atrial fibrillation is chaotic firing with no P waves
Premature Atrial complexes
The document discusses three types of atrial premature complexes:
1. Normally conducted complexes which have an early P wave that conducts normally with a PR interval that may be normal, increased, or decreased and a QRS similar to sinus rhythm.
2. Non-conducted complexes where an early P wave is not followed by a QRS and the P wave is often hidden in the T wave.
3. Complexes with aberrant conduction where the early P wave is followed by a QRS with an abnormal conduction pattern most commonly right bundle branch block but sometimes left bundle branch block.
ECG: Toxin induced First degree Heart Block
A 17-year-old female presented with retrosternal and epigastric burning after consuming 50ml of bleach containing sodium hypochlorite. Her initial ECG showed first-degree AV block with a prolonged PR interval of 320ms that normalized to 140ms on a follow up ECG 3 days later, likely after elimination of the toxin. First-degree AV block is defined as a PR interval over 200ms and can be caused by various conditions. It typically has no symptoms but may reduce exercise tolerance and cause syncope in rare cases of infranodal block or left ventricular dysfunction. Treatment involves discontinuing any medications that may cause AV block and permanent pacing may be indicated in severe cases.
Shadechapter14.ppt [read only]
- Hypertrophy is a thickening of the ventricular wall, while dilation is an enlargement of a chamber to accommodate increased blood volume. Enlargement affects the atria, while hypertrophy affects the ventricles.
- The P wave is used to identify atrial enlargement, while changes in the QRS complex indicate ventricular hypertrophy. Increased duration, amplitude or axis deviation serve as indicators.
- Right atrial enlargement increases the first part of the P wave amplitude. Left atrial enlargement increases the terminal P wave amplitude in V1 and the P wave duration.
Shadechapter08.ppt [read only]
This document provides information on different types of sinus dysrhythmias:
- Sinus dysrhythmias are ECG rhythms that differ from normal sinus rhythm (NSR), which has a rate of 60-100 BPM.
- Sinus bradycardia and sinus tachycardia have the characteristics of NSR but with heart rates slower than 60 BPM or faster than 100 BPM respectively.
- Sinus dysrhythmia has the same characteristics as NSR but with a patterned irregularity of slowing and speeding up corresponding to respiration. Sinus arrest causes pauses in the ECG rhythm until another pacemaker site resumes the rhythm.
1382531 634694433533008750
The document provides guidance on interpreting 12-lead electrocardiograms (ECGs). It discusses evaluating the rate, rhythm, axis, signs of hypertrophy, and evidence of infarction on ECGs. Key steps include determining the heart rate using a "300, 150, 100" counting method and identifying abnormalities in rate, rhythm, conduction, hypertrophy, or signs of injury or necrosis. Interpreting ECGs involves analyzing the P wave, QRS complex, T wave, and ST segment to evaluate for conditions like myocardial infarction, bundle branch blocks, ventricular hypertrophy, and more.
ECG PART 5
This document provides an overview of a course on ECG rhythm interpretation and supraventricular and ventricular arrhythmias. The course objectives are to recognize normal sinus rhythm, the 13 most common rhythm disturbances, and acute myocardial infarction on ECG. The learning modules cover ECG basics, rhythm analysis, normal sinus rhythm, various arrhythmias, and myocardial infarction diagnosis. Example rhythms are provided for arrhythmias including atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, ventricular tachycardia, and ventricular fibrillation. Causes and characteristics of each arrhythmia are described.
ECG PART 6
This document provides an overview of AV junctional blocks and how to interpret ECG rhythms related to different types of AV blocks. It discusses the objectives of ECG rhythm interpretation and covers modules on ECG basics, arrhythmias, AV nodal blocks, and examples of 1st degree, 2nd degree type I and II, and 3rd degree AV blocks. For each type of block, it describes the deviation from normal sinus rhythm and potential etiologies.
Unit 2 ekg module 3-1
This document provides an overview of normal sinus rhythm and common cardiac rhythm disturbances that can be identified on an electrocardiogram (ECG). It aims to teach learners to recognize normal sinus rhythm, identify 13 common arrhythmias, and diagnose a myocardial infarction on a 12-lead ECG. Key topics include the characteristics of normal sinus rhythm, how arrhythmias can form from problems in the sinus node, atrial cells, atrioventricular junction, or ventricular cells, and examples of specific arrhythmias that may result from such problems.
Shadechapter15.ppt [read only]
- The coronary arteries deliver oxygenated blood to the heart while coronary veins return deoxygenated blood to the right atrium. Increased coronary blood flow through vasodilation meets higher oxygen demands.
- The ST segment and T wave can change with myocardial ischemia, injury, or infarction as seen on an electrocardiogram (ECG). ST segment elevation is an early sign of acute myocardial infarction.
- Pathologic Q waves indicate irreversible heart muscle damage from myocardial infarction and help locate the affected area.
Shadechapter13.ppt [read only]
- The ECG detects the mean vector, which is the average of all instantaneous vectors representing the direction of electrical flow in the heart. This mean vector direction is called the mean electrical axis.
- The QRS axis represents the average of all vectors during ventricular depolarization. It normally points downward and leftward but can deviate right or left.
- The limb leads are used to determine if the QRS axis is normal or deviated by examining the orientations of the QRS complex in leads I and aVF.
Atrial arrhythmia
This document summarizes various types of atrial arrhythmias:
- Wandering pacemaker involves the pacemaker site transferring between the SA node and other areas of the atria.
- Premature atrial contractions (PACs) are early atrial impulses followed by normal sinus rhythm.
- Atrial tachycardia overrides the SA node impulse with a rapid atrial rate over 150 bpm.
- Atrial flutter involves the AV node conducting impulses to the ventricles at a ratio, with the ventricular rate either controlled or uncontrolled.
- Atrial fibrillation involves rapid discharges from multiple foci in the atria, so no organized depolarization is detectable
Heart arrth 1
This document outlines the objectives and content of an ECG rhythm interpretation module. The module aims to teach the recognition of normal sinus rhythm, 13 common rhythm disturbances, and acute myocardial infarction on ECGs. It covers ECG basics, analyzing rhythms, normal sinus rhythm, arrhythmias including premature beats, sinus rhythms, and uses examples to explain sinus bradycardia, sinus tachycardia, premature atrial contractions, and premature ventricular contractions.
Stepwise interpretation of ECG - #7 no Dx ID259
This ECG shows a 57-year-old woman with a history of rheumatic fever suffering from dyspnea and fatigue. The ECG reveals normal sinus rhythm, left atrial enlargement, right axis deviation, and right ventricular hypertrophy. There are also ST depressions and negative T waves that are likely due to right ventricular hypertrophy and may indicate ischemia as the patient has signs of heart failure.
En baseline survey 2008
This project took place from 2008-2011 in Cambodia and aimed to improve integrated ANC/PNC and growth monitoring services through collaboration between community health workers and staff at 6 target health centers. A survey found that most VHSG activities involved supporting outreach services. Health center staff did not recognize all VHSG activities and saw financial benefits as most important for collaboration, while VHSG valued emotional support most. The conclusion calls for more sustainable collaboration through technical support and communication to better implement project activities.
Baselinesurvey2008
This project took place from 2008-2011 in Cambodia and aimed to improve integrated ANC/PNC and growth monitoring services through collaboration between community health workers and staff at 6 target health centers. A survey found that most VHSG activities involved supporting outreach services. Health centers did not recognize all VHSG activities and saw financial incentives as more important than the emotional support valued by VHSG. The conclusion calls for more sustainable collaboration through technical support and communication to promote community health.
Stepwise interpretation of ECG - #4 ID383
A 76-year-old woman underwent an ECG examination in her family doctor's office which showed atrial fibrillation with a controlled ventricular rate of 66 beats per minute, as evidenced by the lack of P waves and presence of fibrillatory waves, irregularly irregular rhythm, and normal QRS axis, duration, and absence of signs of right or left ventricular hypertrophy, bundle branch blocks, myocardial infarction, or other abnormalities.
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Shadechapter12.ppt [read only]
This document discusses different types of atrioventricular (AV) heart blocks. It defines heart blocks as delays or interruptions in conduction between the atria and ventricles. It then proceeds to describe the characteristics of 1st-degree AV block, 2nd-degree AV block types I and II, and 3rd-degree AV block. Specifically, it notes that 2nd-degree type I block shows a regularly irregular rhythm with a progressively lengthening PR interval, while 2nd-degree type II block maintains a constant PR interval with more P waves than QRS complexes. 3rd-degree block results in independent atrial and ventricular rhythms that can decrease cardiac output if the ventricular rate is too slow.
Shadechapter09.ppt [read only]
Atrial dysrhythmias originate outside the SA node and are caused by three mechanisms: increased automaticity, triggered activity, and reentry. Key characteristics include abnormal P waves and P-R intervals with normal QRS complexes. Wandering atrial pacemaker produces changing P waves as the pacemaker site shifts. Premature atrial complexes originate outside the SA node and cause rhythm irregularity with different P wave morphologies. Atrial tachycardia and multifocal atrial tachycardia involve rapid atrial rates while supraventricular tachycardia cannot identify a specific origin. Atrial flutter shows sawtooth waves at 250-350 bpm and atrial fibrillation is chaotic firing with no P waves
Premature Atrial complexes
The document discusses three types of atrial premature complexes:
1. Normally conducted complexes which have an early P wave that conducts normally with a PR interval that may be normal, increased, or decreased and a QRS similar to sinus rhythm.
2. Non-conducted complexes where an early P wave is not followed by a QRS and the P wave is often hidden in the T wave.
3. Complexes with aberrant conduction where the early P wave is followed by a QRS with an abnormal conduction pattern most commonly right bundle branch block but sometimes left bundle branch block.
ECG: Toxin induced First degree Heart Block
A 17-year-old female presented with retrosternal and epigastric burning after consuming 50ml of bleach containing sodium hypochlorite. Her initial ECG showed first-degree AV block with a prolonged PR interval of 320ms that normalized to 140ms on a follow up ECG 3 days later, likely after elimination of the toxin. First-degree AV block is defined as a PR interval over 200ms and can be caused by various conditions. It typically has no symptoms but may reduce exercise tolerance and cause syncope in rare cases of infranodal block or left ventricular dysfunction. Treatment involves discontinuing any medications that may cause AV block and permanent pacing may be indicated in severe cases.
Shadechapter14.ppt [read only]
- Hypertrophy is a thickening of the ventricular wall, while dilation is an enlargement of a chamber to accommodate increased blood volume. Enlargement affects the atria, while hypertrophy affects the ventricles.
- The P wave is used to identify atrial enlargement, while changes in the QRS complex indicate ventricular hypertrophy. Increased duration, amplitude or axis deviation serve as indicators.
- Right atrial enlargement increases the first part of the P wave amplitude. Left atrial enlargement increases the terminal P wave amplitude in V1 and the P wave duration.
Shadechapter08.ppt [read only]
This document provides information on different types of sinus dysrhythmias:
- Sinus dysrhythmias are ECG rhythms that differ from normal sinus rhythm (NSR), which has a rate of 60-100 BPM.
- Sinus bradycardia and sinus tachycardia have the characteristics of NSR but with heart rates slower than 60 BPM or faster than 100 BPM respectively.
- Sinus dysrhythmia has the same characteristics as NSR but with a patterned irregularity of slowing and speeding up corresponding to respiration. Sinus arrest causes pauses in the ECG rhythm until another pacemaker site resumes the rhythm.
1382531 634694433533008750
The document provides guidance on interpreting 12-lead electrocardiograms (ECGs). It discusses evaluating the rate, rhythm, axis, signs of hypertrophy, and evidence of infarction on ECGs. Key steps include determining the heart rate using a "300, 150, 100" counting method and identifying abnormalities in rate, rhythm, conduction, hypertrophy, or signs of injury or necrosis. Interpreting ECGs involves analyzing the P wave, QRS complex, T wave, and ST segment to evaluate for conditions like myocardial infarction, bundle branch blocks, ventricular hypertrophy, and more.
ECG PART 5
This document provides an overview of a course on ECG rhythm interpretation and supraventricular and ventricular arrhythmias. The course objectives are to recognize normal sinus rhythm, the 13 most common rhythm disturbances, and acute myocardial infarction on ECG. The learning modules cover ECG basics, rhythm analysis, normal sinus rhythm, various arrhythmias, and myocardial infarction diagnosis. Example rhythms are provided for arrhythmias including atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, ventricular tachycardia, and ventricular fibrillation. Causes and characteristics of each arrhythmia are described.
ECG PART 6
This document provides an overview of AV junctional blocks and how to interpret ECG rhythms related to different types of AV blocks. It discusses the objectives of ECG rhythm interpretation and covers modules on ECG basics, arrhythmias, AV nodal blocks, and examples of 1st degree, 2nd degree type I and II, and 3rd degree AV blocks. For each type of block, it describes the deviation from normal sinus rhythm and potential etiologies.
Unit 2 ekg module 3-1
This document provides an overview of normal sinus rhythm and common cardiac rhythm disturbances that can be identified on an electrocardiogram (ECG). It aims to teach learners to recognize normal sinus rhythm, identify 13 common arrhythmias, and diagnose a myocardial infarction on a 12-lead ECG. Key topics include the characteristics of normal sinus rhythm, how arrhythmias can form from problems in the sinus node, atrial cells, atrioventricular junction, or ventricular cells, and examples of specific arrhythmias that may result from such problems.
Shadechapter15.ppt [read only]
- The coronary arteries deliver oxygenated blood to the heart while coronary veins return deoxygenated blood to the right atrium. Increased coronary blood flow through vasodilation meets higher oxygen demands.
- The ST segment and T wave can change with myocardial ischemia, injury, or infarction as seen on an electrocardiogram (ECG). ST segment elevation is an early sign of acute myocardial infarction.
- Pathologic Q waves indicate irreversible heart muscle damage from myocardial infarction and help locate the affected area.
Shadechapter13.ppt [read only]
- The ECG detects the mean vector, which is the average of all instantaneous vectors representing the direction of electrical flow in the heart. This mean vector direction is called the mean electrical axis.
- The QRS axis represents the average of all vectors during ventricular depolarization. It normally points downward and leftward but can deviate right or left.
- The limb leads are used to determine if the QRS axis is normal or deviated by examining the orientations of the QRS complex in leads I and aVF.
Atrial arrhythmia
This document summarizes various types of atrial arrhythmias:
- Wandering pacemaker involves the pacemaker site transferring between the SA node and other areas of the atria.
- Premature atrial contractions (PACs) are early atrial impulses followed by normal sinus rhythm.
- Atrial tachycardia overrides the SA node impulse with a rapid atrial rate over 150 bpm.
- Atrial flutter involves the AV node conducting impulses to the ventricles at a ratio, with the ventricular rate either controlled or uncontrolled.
- Atrial fibrillation involves rapid discharges from multiple foci in the atria, so no organized depolarization is detectable
Heart arrth 1
This document outlines the objectives and content of an ECG rhythm interpretation module. The module aims to teach the recognition of normal sinus rhythm, 13 common rhythm disturbances, and acute myocardial infarction on ECGs. It covers ECG basics, analyzing rhythms, normal sinus rhythm, arrhythmias including premature beats, sinus rhythms, and uses examples to explain sinus bradycardia, sinus tachycardia, premature atrial contractions, and premature ventricular contractions.
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Stepwise interpretation of ECG - #7 no Dx ID259
This ECG shows a 57-year-old woman with a history of rheumatic fever suffering from dyspnea and fatigue. The ECG reveals normal sinus rhythm, left atrial enlargement, right axis deviation, and right ventricular hypertrophy. There are also ST depressions and negative T waves that are likely due to right ventricular hypertrophy and may indicate ischemia as the patient has signs of heart failure.
En baseline survey 2008
This project took place from 2008-2011 in Cambodia and aimed to improve integrated ANC/PNC and growth monitoring services through collaboration between community health workers and staff at 6 target health centers. A survey found that most VHSG activities involved supporting outreach services. Health center staff did not recognize all VHSG activities and saw financial benefits as most important for collaboration, while VHSG valued emotional support most. The conclusion calls for more sustainable collaboration through technical support and communication to better implement project activities.
Baselinesurvey2008
This project took place from 2008-2011 in Cambodia and aimed to improve integrated ANC/PNC and growth monitoring services through collaboration between community health workers and staff at 6 target health centers. A survey found that most VHSG activities involved supporting outreach services. Health centers did not recognize all VHSG activities and saw financial incentives as more important than the emotional support valued by VHSG. The conclusion calls for more sustainable collaboration through technical support and communication to promote community health.
Stepwise interpretation of ECG - #4 ID383
A 76-year-old woman underwent an ECG examination in her family doctor's office which showed atrial fibrillation with a controlled ventricular rate of 66 beats per minute, as evidenced by the lack of P waves and presence of fibrillatory waves, irregularly irregular rhythm, and normal QRS axis, duration, and absence of signs of right or left ventricular hypertrophy, bundle branch blocks, myocardial infarction, or other abnormalities.
Stepwise interpretation of ECG - #05 no Dx ID175
A 58-year-old man with a history of coronary artery disease presented with an ECG showing normal sinus rhythm of 88 beats per minute. The ECG revealed left bundle branch block, evidenced by a prolonged QRS duration of 145 milliseconds with characteristic morphology. Left bundle branch block can mask signs of left ventricular hypertrophy and prior myocardial infarction. It is also associated with secondary repolarization abnormalities like ST depression and negative T waves in leads with broad R waves. The final diagnosis was normal sinus rhythm with left bundle branch block.
Lead errors introduction
Incorrect placement of electrodes on a patient's body during an ECG can lead to diagnostic errors. A study found that electrode misplacement caused artifacts in 0.4% of ECGs at an outpatient clinic but in 4% of ECGs in the ICU. Lead reversals and misplacement of limb and ground cables are common errors that can change the ECG pattern. Reversals of unipolar chest leads like V1-V3 can also occur due to incorrect electrode placement or detached cables.
stepwise interpretation of ECG ID279 RVH
This ECG summary is for a 57-year-old woman with a history of rheumatic fever and recent dyspnea and fatigue. The ECG shows normal sinus rhythm, left atrial enlargement, right axis deviation, and right ventricular hypertrophy. ST depression is seen in leads II, III, aVF and chest leads V1-V3, which may be due to right ventricular hypertrophy. Negative T waves are also seen in leads V4-V6, which can occur in heart failure and may be caused by ischemia.
Stepwise interpretation of ECG - #1 ID 380
A 53-year-old man received an ECG in the pre-anesthesia clinic. The ECG interpreter found normal sinus rhythm at a rate of 60 beats per minute, with normal P waves, PR interval, QRS axis and duration, and no signs of chamber enlargement, bundle branch blocks, ventricular hypertrophy, or myocardial infarction. The final diagnosis was a completely normal ECG.
Stepwise interpretation of ECG - #912 no Dx ID111
A 56-year-old man presented with an episode of syncope. An ECG showed sinus rhythm with complete heart block, where the atrial rate was 80/min and ventricular rate was 43/min. The dissociation between the P waves and QRS complexes indicated complete heart block. The narrow QRS complexes and normal axis suggested the escape pacemaker was in the AV junction, resulting in an escape junctional rhythm controlling the ventricles. The ECG was otherwise normal.
Stepwise interpretation of ECG ID122
A 50-year-old man presented with palpitations. An ECG showed atrial flutter with a variable atrioventricular block and a ventricular rate of 107 beats per minute. The QRS complexes were normal with no signs of bundle branch block or myocardial infarction. The final diagnosis was atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute.
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The document proposes a generic statistical business process model to standardize terminology and mapping of business processes across statistical organizations. It describes the development of the model based on existing national models and its key features, including that it is not linear and allows for iterative loops. The model could be relevant to the SDMX initiative for common terminology and mapping statistical processes if inputs and outputs use SDMX formats. Next steps include gathering implementation experiences to inform further development.
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Stepwise interpretation of ECG - #1 ID 380
This document summarizes the interpretation of an electrocardiogram (ECG) for a 53-year-old man. The ECG shows normal sinus rhythm at a rate of 60 beats per minute, with normal P waves, PR interval, QRS duration and axis, and no signs of atrial or ventricular enlargement, bundle branch blocks, or myocardial infarction. The overall interpretation is that the ECG is normal.
Stepwise interpretation of ECG - #1 ID 380
A 53-year-old man received an ECG in the pre-anesthesia clinic. The ECG interpreter found normal sinus rhythm at a rate of 60 beats per minute, with normal P waves, PR interval, QRS axis and duration, and no signs of chamber enlargement, bundle branch blocks, ventricular hypertrophy, or myocardial infarction. The final diagnosis was a completely normal ECG.
Stepwise interpretation of ECG - #01 ID 380
A 53-year-old man received an ECG in the pre-anesthesia clinic. The ECG interpreter found normal sinus rhythm at a rate of 60 beats per minute, with normal P waves, PR interval, QRS axis and duration, and no signs of chamber enlargement, bundle branch blocks, ventricular hypertrophy, or myocardial infarction. The final diagnosis was a completely normal ECG.
Stepwise interpretation of ECG - #1 ID 380
A 53-year-old man received an ECG in the pre-anesthesia clinic. The ECG interpreter found normal sinus rhythm at a rate of 60 beats per minute, with normal P waves, PR interval, QRS axis and duration, and no signs of chamber enlargement, bundle branch blocks, ventricular hypertrophy, or myocardial infarction. The final diagnosis was a completely normal ECG.
stepwise interpretation ECG #1
A 53-year-old man received an ECG in the pre-anesthesia clinic. The ECG interpreter found normal sinus rhythm at a rate of 60 beats per minute, with normal P waves, PR interval, QRS axis and duration, and no signs of chamber enlargement, bundle branch blocks, ventricular hypertrophy, or myocardial infarction. The final diagnosis was a completely normal ECG.
#01 ID380 - NML
This document summarizes the stepwise interpretation of a 53-year-old man's ECG in the pre-anesthesia clinic. The interpreter found the man to have a normal sinus rhythm of 60 beats per minute, with normal P waves, PR interval, QRS axis and duration, and no signs of atrial or ventricular enlargement, bundle branch blocks, or evidence of myocardial infarction. The final diagnosis was a completely normal ECG and normal sinus rhythm.
Stepwise interpretation - ECG #1
A 53-year-old man received an ECG in the pre-anesthesia clinic. The ECG interpreter found normal sinus rhythm at a rate of 60 beats per minute, with normal P waves, PR interval, QRS axis and duration, and no signs of chamber enlargement, bundle branch blocks, ventricular hypertrophy, or myocardial infarction. The final diagnosis was a completely normal ECG.
ECG #1 - ID 380 – Normal ECG
The ECG is for a 53-year-old man undergoing pre-anesthesia evaluation. The interpreter found normal sinus rhythm at a rate of 60 bpm, normal P waves and PR interval, normal QRS axis and duration with no evidence of conduction blocks, no signs of chamber enlargement or hypertrophy, and normal ST segments and T waves. The final diagnosis was a normal ECG.
Stepwise interpretation of ECG - #06 no Dx ID168
This document summarizes the stepwise interpretation of an ECG for a 78 year old woman with a heart murmur. It was found that she had sinus rhythm at 77 beats per minute with sinus arrhythmia and first degree AV block. The QRS duration was normal with no signs of bundle branch blocks. There were findings of left ventricular hypertrophy with ST-T abnormalities indicating a strain pattern. The final diagnosis was sinus rhythm with sinus arrhythmia, first degree AV block, and left ventricular hypertrophy with repolarization abnormality.
Stepwise interpretation of ECG - #6 no Dx ID168
This document summarizes the stepwise interpretation of an ECG for a 78 year old woman with a heart murmur. It finds sinus rhythm at 77 beats per minute with sinus arrhythmia and first degree AV block. The QRS axis and duration are normal with no signs of bundle branch blocks. There are findings of left ventricular hypertrophy with ST-T abnormalities indicating strain pattern. No signs of myocardial infarction are seen.
Stepwise interpretation of ECG - #06 no Dx ID168
This document summarizes the stepwise interpretation of an ECG for a 78 year old woman with a heart murmur. It finds sinus rhythm at 77 beats per minute with sinus arrhythmia and first degree AV block. The QRS axis and duration are normal with no signs of bundle branch blocks. There are findings of left ventricular hypertrophy with ST-T abnormalities indicating strain pattern. No signs of myocardial infarction are seen.
Stepwise interpretation of ECG - #06 no Dx ID168
A 78-year-old woman presented with a heart murmur. The ECG showed sinus rhythm at 77 beats per minute with sinus arrhythmia. There was first-degree AV block seen by a prolonged PR interval of 230 ms. Findings also included left ventricular hypertrophy with ST-T abnormalities consistent with left ventricular strain.
stepwise interpretation ECG #6
This document summarizes the stepwise interpretation of an ECG for a 78 year old woman with a heart murmur. It was found that she had sinus rhythm at 77 beats per minute with sinus arrhythmia. She also had first degree AV block seen by a prolonged PR interval of 230 ms. Examination of the QRS complexes and axes found normal duration and no signs of bundle branch blocks. There were findings of left ventricular hypertrophy seen with ST-T abnormalities indicating strain pattern. No signs of myocardial infarction were seen.
ECG #2 - ID 352 - Premature Atrial Complexes
A 62-year-old man presented with palpitations. An analysis of his ECG found sinus rhythm at 83 bpm with premature atrial complexes, where every third P wave was premature in a pattern of trigeminy. The QRS complexes, ST segments, and T waves were normal with no signs of right or left atrial enlargement, bundle branch blocks, ventricular hypertrophy, or myocardial infarction. The final diagnosis was sinus rhythm with atrial premature complexes in a pattern of trigeminy, but an otherwise normal ECG.
ID 352 –Sinus rhythm With premature atrial complex
A 62-year-old man presented with palpitations. An analysis of his ECG found sinus rhythm at 83 bpm with premature atrial complexes, where every third P wave was premature in a pattern of trigeminy. The ECG further showed normal P waves, QRS axis, duration and complexes, as well as normal ST segments and T waves. The final diagnosis was sinus rhythm with atrial premature complexes in a pattern of trigeminy, but an otherwise normal ECG.
Stepwise interpretation of ECG - #08 no Dx ID478
This document describes the stepwise interpretation of an ECG for a 58-year-old man with dilated cardiomyopathy. It was determined that the patient has normal sinus rhythm at a rate of 97 beats per minute, evidence of biatrial enlargement, left ventricular hypertrophy, and repolarization abnormality but no signs of myocardial infarction.
Ecg case
This document contains 6 ECG readings from patients presenting with various chest complaints. For each reading, it provides the clinical interpretation of the ECG findings and recommends next steps in management, such as administering thrombolytics, referring for angiography, or implanting a pacemaker. Common presentations included prior heart attacks, heart block, acute myocardial infarction, and supraventricular tachycardia. The recommended treatments were aimed at addressing the underlying cardiac issues and providing symptom relief.
Cardiac arrythmias
This document provides information on cardiac arrhythmias:
- It describes the normal cardiac conduction system and identifies structures involved like the SA node, AV node, Bundle of His, and Purkinje fibers.
- Common arrhythmias are defined including sinus bradycardia, sinus tachycardia, premature atrial contractions, atrial fibrillation, atrial flutter, junctional rhythms, premature ventricular contractions, ventricular tachycardia, ventricular fibrillation, and asystole.
- For each arrhythmia, the heart rate, rhythm, P wave presence, PR interval, and QRS duration are outlined to aid in identification. Understanding the normal cardiac cycle is essential for recognizing and
Stepwise interpretation of ECG ID168
A 78-year-old woman presented with a heart murmur. The ECG showed sinus rhythm at 77 beats per minute with sinus arrhythmia and first-degree AV block. There was no evidence of atrial enlargement and the QRS duration was normal with no conduction abnormalities. Signs of left ventricular hypertrophy and ST-T abnormalities were present, consistent with a strain pattern, but no signs of prior myocardial infarction.
ECG #6 - ID 168 LVH
The document summarizes the stepwise interpretation of an ECG for a 78-year-old woman with a heart murmur. It finds sinus rhythm at 77 beats per minute with sinus arrhythmia and first-degree AV block. There is also evidence of left ventricular hypertrophy with ST-T abnormalities and no signs of myocardial infarction.
Similar to Stepwise interpretation of ECG - #3 ID659 (20)
ID 352 –Sinus rhythm With premature atrial complex
ID 352 –Sinus rhythm With premature atrial complex
More from Anas Nader
ECG #14 - ID 123 - Atrial Tachycardia
A 67-year-old woman presented with palpitations. An ECG showed a narrow-QRS tachycardia at a rate of 160 beats per minute, with visible P waves preceding each QRS complex. The P waves were negative in leads II, III, aVF and V3-V6, with a PR interval of 140 msec. Based on these characteristics, the patient was diagnosed with atrial tachycardia originating from the atria.
ECG #13 - ID 419 - EAR IRBBB
This ECG shows an ectopic atrial rhythm originating from a low atrial region at a rate of 70 beats per minute, as well as an incomplete right bundle branch block. P waves are clearly seen and negative in several leads, with a PR interval of 180ms indicating the rhythm is not junctional. The QRS axis is normal and duration is 100ms with an rSR' pattern consistent with incomplete right bundle branch block. The final diagnosis is an ectopic atrial rhythm at 70bpm with incomplete right bundle branch block.
ECG #12 - ID 111 - CHB
This document discusses the stepwise interpretation of an ECG for a patient. It identifies that the patient, a 56-year-old man who had an episode of syncope, has sinus rhythm with complete heart block. The atrial rate is 80/min while the ventricular rate is 43/min, showing dissociation between the two rhythms. The QRS complexes originate from the AV junction at a rate of 43/min, indicating an escape junctional rhythm. The final diagnosis is sinus rhythm with complete heart block and an escape junctional rhythm supplying the ventricles.
ECG #11 - ID 108 - 2nd degree AV block
This document summarizes the ECG findings for a 58-year-old man presenting to the emergency department with 2nd degree AV block, Mobitz type 1. The ECG shows regular sinus rhythm at a rate of 88 beats per minute with intermittent conduction block such that every third P-wave is not followed by a QRS complex, resulting in a ventricular rate of 59 beats per minute. Further analysis of the ECG found normal QRS axis, duration and morphology with no signs of infarction, hypertrophy, or other abnormalities. The final diagnosis was sinus rhythm with Mobitz type 1 2nd degree AV block and a ventricular rate of 58 beats per minute.
ECG #10 - ID122 - Atrial Flutter
This document describes the stepwise interpretation of ECG ID 122, which shows atrial flutter with variable atrioventricular block and a ventricular rate of 107 beats per minute in a 50-year-old man complaining of palpitations. The interpretation examines the P waves, QRS complex, QRS duration, signs of ventricular hypertrophy or myocardial infarction, and T waves. The final diagnosis is atrial flutter with variable AV block and a ventricular rate of 107 beats per minute.
ECG #9 - ID594a - acute ASMI
This ECG shows signs of an acute antero-septal myocardial infarction in a 49-year old man presenting with chest pain, requiring urgent therapy. The ECG reveals normal sinus rhythm, a normal QRS axis and duration, and marked ST elevation in leads V1-V4, consistent with an antero-septal injury pattern diagnostic of an acute antero-septal infarction.
ECG#8 - ID478 - LVH BAE
The document discusses an ECG reading of a 58-year-old man with dilated cardiomyopathy. It finds evidence of biatrial enlargement from enlarged P waves and left ventricular hypertrophy shown by a widened QRS complex and ST abnormality, with a heart rate of 97 beats per minute and no signs of myocardial infarction.
ECG #7 - ID 279 - RVH
This ECG belongs to a 57-year-old woman with a history of rheumatic fever and recent symptoms of severe dyspnea and fatigue. The ECG shows normal sinus rhythm, left atrial enlargement, right axis deviation, and right ventricular hypertrophy. There are also ST depressions and negative T waves that may indicate ischemia from heart failure.
ECG #5 - ID 168 - Left bundle branch block
A 58-year-old man followed for coronary artery disease presented with an ECG showing sinus rhythm at 88 beats per minute, a prolonged QRS duration of 145 milliseconds consistent with left bundle branch block, and no evidence of right or left ventricular hypertrophy or atrial enlargement. The left bundle branch block precludes diagnosing left ventricular hypertrophy and can mask underlying myocardial infarction.
ECG #4 - ID 383 – Atrial fibrillation
A 76-year-old woman underwent an ECG examination in her family doctor's office which showed atrial fibrillation with an irregularly irregular ventricular rhythm of 66 beats per minute and no P waves. The QRS complexes were normal with no signs of conduction abnormalities, ventricular hypertrophy, or prior myocardial infarction. The final diagnosis was atrial fibrillation with a controlled ventricular rate of 66 bpm and no other abnormalities.
Atrio-ventricular dissociation
Atrio-ventricular dissociation occurs when the atrial and ventricular rhythms are independent of each other. It can happen when the atrial rate slows below the intrinsic ventricular rate, or due to inappropriate acceleration of the ventricular rate. Typically in AV dissociation the distal pacemaker, such as the ventricles, beats faster than the proximal pacemaker like the atria. In complete heart block the proximal pacemaker usually beats faster than the distal one. However, there are exceptions to using pacemaker rates to distinguish the two.
Lead errors: reversal of limb leads
This document discusses common errors involving limb leads in electrocardiograms (ECGs), including:
1) Lead reversal is a common error, such as switching the right and left arm leads. This can cause leads like aVR and aVL to be reversed.
2) Misplacing the ground cable, such as attaching it to the right arm instead of the right leg, is another error.
3) Complex misplacements of the limb leads are less common. Examples provided demonstrate how specific lead errors can cause abnormalities to appear or disappear on ECG tracings.
Stepwise interpretation of ECG - #9 no Dx ID 594
This ECG shows a 49-year-old man experiencing severe chest pain for 1 hour who is presenting with an antero-septal injury pattern consistent with an acute myocardial infarction requiring urgent therapy. The ECG shows normal sinus rhythm at 84 beats per minute, a normal PR interval and QRS axis, and no signs of ventricular hypertrophy. It does reveal marked ST elevation in leads V1-V4, confirming the diagnosis of an acute antero-septal infarction.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm originating outside the sinoatrial node at a rate of 75 beats per minute. The P waves precede each QRS complex but have an abnormal axis. There is also evidence of incomplete right bundle branch block seen by a widened QRS complex with a duration of 100 milliseconds and rSR' pattern. The final diagnosis is an ectopic atrial rhythm at 75 bpm with incomplete right bundle branch block and no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm originating outside the sinoatrial node at a rate of 75 beats per minute. The P waves have an abnormal axis and precede each QRS complex, indicating the atrial origin. There is also an incomplete right bundle branch block seen by the prolonged QRS duration of 100 milliseconds and rSR' pattern. The final diagnosis is an ectopic atrial rhythm at a rate of 75 bpm with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm at a rate of 70 beats per minute with an incomplete right bundle branch block pattern. The QRS axis is normal and the duration is 100 msec. with an rSR' configuration. There are no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves. The final diagnosis is an ectopic atrial rhythm at 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
This ECG shows an ectopic atrial rhythm at a rate of 70 beats per minute with an incomplete right bundle branch block pattern. The QRS axis is normal and the duration is 100 msec. with an rSR' configuration. There are no signs of ventricular hypertrophy, myocardial infarction, or abnormal ST segments or T waves. The final diagnosis is an ectopic atrial rhythm at 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
Ectopic atrial rhythm at a rate of 75 beats per minute. P waves are clearly seen and negative in several leads, indicating they do not originate from the sinus node but likely a low atrial region. There is also an incomplete right bundle branch block present as shown by a prolonged QRS duration of 100 milliseconds with an rSR' pattern. The final diagnosis is an ectopic atrial rhythm at a rate of 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #13 no Dx ID 419
Ectopic atrial rhythm at a rate of 75 beats per minute. P waves are clearly seen and negative in several leads, indicating they do not originate from the sinus node but likely a low atrial region. There is also an incomplete right bundle branch block present as shown by a widened QRS duration of 100 milliseconds with an rSR' pattern. The final diagnosis is an ectopic atrial rhythm at a rate of 75 beats per minute with an incomplete right bundle branch block.
Stepwise interpretation of ECG - #12 no Dx ID 111
A 56-year-old man presented with an episode of syncope. An ECG was performed which showed sinus rhythm with complete heart block, where the atrial rate was 80/min and the ventricular rate was 43/min. The dissociation of the P waves and QRS complexes along with the narrow QRS escape rhythm indicated the ventricular activation was coming from the AV junctional area. The ECG was otherwise normal.
More from Anas Nader (20)
Stepwise interpretation of ECG - #3 ID659
- 1. Stepwise interpretation of ECG ID 619
- 2. ID 619 68 year old man in the Emergency Department after an accidental fall
- 3. ID 619 68 year old man in the Emergency Department after an accidental fall Can you see P waves?
- 4. ID 619 – Sinus rhythm with frequent premature ventricular complexes Yes – There is sinus rhythm, rate 100/min, with frequent premature ventricular complexes
- 5. ID619 - Sinus rhythm with frequent premature ventricular complexes The PR interval is normal – There is no left or right atrial enlargement
- 6. ID619 - Sinus rhythm with frequent premature ventricular complexes The PrR interval is normal – There is no left or right atrial enlargement
- 7. ID619 - Sinus rhythm with frequent premature ventricular complexes Let’s now look at the QRS complexes: There is normal QRS axis (between O and 90 degrees)
- 8. ID619 - Sinus rhythm with frequent premature ventricular complexes The QRS complexes that follow the P waves have a normal duration – There is no right bundle branch block, left bundle branch block or non-specific block
- 9. ID619 - Sinus rhythm with frequent premature ventricular complexes There is no evidence of right or left ventricular hypertrophy
- 10. ID619 - Sinus rhythm with frequent premature ventricular complexes There are no QRS signs of myocardial infarction
- 11. ID619 - Sinus rhythm with frequent premature ventricular complexes The ST segment and T waves are normal
- 12. ID619 – Final diagnosis: Sinus rhythm with frequent premature ventricular complexes Otherwise, a normal ECG The ST segment and T waves are normal