Stepwise interpretation of ECG ID123
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A 67-year old woman presented with palpitations. Her ECG showed a narrow-QRS tachycardia at a rate of 160 beats per minute. P waves were visible preceding the QRS complexes and were negative in leads II, III, aVF and V3-V6, with a PR interval of 140 msec. The diagnosis was determined to be atrial tachycardia based on the ECG findings.
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Stepwise interpretation of ECG ID123
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. The diagnosis was determined to be atrial tachycardia based on the ECG findings.
Stepwise interpretation of ECG - #14 no Dx ID123
A 67-year-old woman presented with palpitations. Her ECG showed a narrow-QRS tachycardia of 160 beats per minute. P waves were visible and preceded the QRS complexes, with a PR interval of 140 msec. The arrhythmia was diagnosed as atrial tachycardia based on the P wave morphology and timing.
Stepwise interpretation of ECG - #14 no Dx ID123
A 67-year-old woman presented with palpitations. Her ECG showed a narrow-QRS tachycardia at a rate of 160 beats per minute. P waves were visible and preceded the QRS complexes, with negative P waves in leads II, III, aVF, and V3-V6. The PR interval was 140 milliseconds. Based on these characteristics, the patient was diagnosed with atrial tachycardia. Additional analysis found a normal QRS axis and duration, no ventricular hypertrophy, no signs of infarction, and normal T waves.
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.
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.
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.
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Stepwise interpretation of ECG ID123
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. The diagnosis was determined to be atrial tachycardia based on the ECG findings.
Stepwise interpretation of ECG - #14 no Dx ID123
A 67-year-old woman presented with palpitations. Her ECG showed a narrow-QRS tachycardia of 160 beats per minute. P waves were visible and preceded the QRS complexes, with a PR interval of 140 msec. The arrhythmia was diagnosed as atrial tachycardia based on the P wave morphology and timing.
Stepwise interpretation of ECG - #14 no Dx ID123
A 67-year-old woman presented with palpitations. Her ECG showed a narrow-QRS tachycardia at a rate of 160 beats per minute. P waves were visible and preceded the QRS complexes, with negative P waves in leads II, III, aVF, and V3-V6. The PR interval was 140 milliseconds. Based on these characteristics, the patient was diagnosed with atrial tachycardia. Additional analysis found a normal QRS axis and duration, no ventricular hypertrophy, no signs of infarction, and normal T waves.
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.
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.
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.
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 - #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 #9
A 49-year-old man presented to the emergency department with 1 hour of severe anterior chest pain. An ECG showed normal sinus rhythm at 84 beats per minute with no signs of right or left atrial enlargement and a normal QRS axis and duration. The ECG revealed marked ST elevation in leads V1-V4, consistent with an antero-septal injury pattern diagnostic of an acute antero-septal myocardial infarction.
Wide complex tachycardia drneeraj
This document discusses criteria for differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) using electrocardiograms (ECGs) of patients presenting with wide complex tachycardia. It outlines definitions of VT and SVT, as well as diagnostic criteria including Brugada criteria, the lead aVR algorithm, and the RWPT (R wave to peak time) criterion. The document then analyzes ECGs of two case studies, concluding that the first is VT and the second is SVT with aberrant conduction based on application of the discussed criteria. It recognizes Prevost and Batelli for inventing defibrillation in 1899 by discovering electric shocks could
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Wide complex tachycardia is identified on an ECG by a heart rate over 100 bpm and a QRS duration over 0.12 seconds for at least 3 consecutive beats. The ACC/AHA/ESC guideline proposes an algorithm for differentiating types of wide complex tachycardia using ECG patterns. This includes algorithms from the Brugada working group to distinguish ventricular tachycardia from pre-excited tachycardia, and the aVR Vereckei algorithm which analyzes the velocity ratio between initial and terminal portions of the QRS complex in lead aVR to identify ventricular tachycardia or supraventricular tachycardia.
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The document discusses various electrocardiogram (ECG) criteria for differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with aberrancy presenting with a wide QRS complex tachycardia. It outlines criteria from Sandler and Marriott (1965), Wellens (1978), Kindwall (1988), Brugada (1991), Vereckei (2008) and Pava (2010). Key criteria that favor VT include QRS duration >140ms, extreme left axis, AV dissociation, monophasic R wave in V1, R/S ratio <1 in V6, and notching of the S wave in V1.
Basic of ecg interpretation
The document provides an overview of electrocardiogram (ECG or EKG) interpretation. It discusses cardiac anatomy and physiology relevant to understanding ECGs. The basics of the 12-lead ECG system are explained, including the six limb leads and six precordial leads. Components of the ECG waveform like the P, QRS, and T waves are defined. An 8-step method for ECG interpretation is outlined, beginning with analyzing the rhythm and rate, and then evaluating each waveform and interval. Key points include determining normal durations for the P wave, PR interval, QRS complex, QT interval, and identifying abnormalities. The summary restates normal findings for a sinus rhythm ECG.
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1. Wide complex tachycardia (WCT) refers to tachycardias with a heart rate over 100 beats per minute and a QRS duration greater than 0.12 seconds.
2. WCT can be caused by irregular rhythms like atrial fibrillation or regular rhythms like supraventricular tachycardia with aberrant conduction or ventricular tachycardia.
3. Management depends on hemodynamic stability and rhythm characteristics - synchronized cardioversion is first-line for unstable patients, while antiarrhythmic drugs or pacing are used for stable patients depending on the underlying rhythm.
Wide complex tacycardia
Wide QRS tachycardia requires differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with aberrancy. The document outlines the following approach:
1. Obtain history, physical exam, and 12-lead electrocardiogram (ECG) findings to help determine VT vs SVT. Features like AV dissociation or axis deviation favor VT.
2. Use criteria/algorithms like Wellens, Brugada, Vereckei (incorporating lead aVR) to analyze ECG morphology. A majority of criteria must be met to diagnose VT.
3. Consider electrophysiological testing like measuring His-ventricular intervals
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,
basicsecg
,
ecg
,
arrthymias
Case-Based ECG
The document outlines the 10 step approach to interpreting electrocardiograms (ECGs) and presents two case studies from remote Aboriginal communities. It details the steps of an ECG including assessing the rate, rhythm, waves, intervals, segments, and complexes. The first case involves a 10 year old girl named Thomasina presenting with jerky movements and fever, who is diagnosed with rheumatic fever based on her ECG and blood tests. The second case describes a pilot named Frank who develops palpitations and is found to be in supraventricular tachycardia based on his ECG, which is terminated with carotid sinus massage.
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This document provides an overview of ECG interpretation presented by Dr. Raghoba. It outlines the normal ECG components and measurements. It then describes various arrhythmias including tachycardias like sinus tachycardia, atrial fibrillation and ventricular tachycardia. Bradycardias like sinus bradycardia and heart block are also reviewed. Common ECG findings for myocardial infarction, bundle branch blocks, ectopics and structural heart disease are presented. Electrolyte disturbances and other miscellaneous ECG patterns are also discussed.
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This document outlines a standardized method for interpreting 12-lead electrocardiograms (ECGs). The method involves analyzing six major sections in a specific order: heart rate, PR interval, QRS duration, QT interval, QRS axis, and waveforms. Each section is analyzed to identify any abnormalities, including intervals outside normal ranges or irregular waveforms. After following this method, the interpreter provides an overall interpretation of the ECG as normal or abnormal, listing any findings.
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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 - #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 #9
A 49-year-old man presented to the emergency department with 1 hour of severe anterior chest pain. An ECG showed normal sinus rhythm at 84 beats per minute with no signs of right or left atrial enlargement and a normal QRS axis and duration. The ECG revealed marked ST elevation in leads V1-V4, consistent with an antero-septal injury pattern diagnostic of an acute antero-septal myocardial infarction.
Wide complex tachycardia drneeraj
This document discusses criteria for differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) using electrocardiograms (ECGs) of patients presenting with wide complex tachycardia. It outlines definitions of VT and SVT, as well as diagnostic criteria including Brugada criteria, the lead aVR algorithm, and the RWPT (R wave to peak time) criterion. The document then analyzes ECGs of two case studies, concluding that the first is VT and the second is SVT with aberrant conduction based on application of the discussed criteria. It recognizes Prevost and Batelli for inventing defibrillation in 1899 by discovering electric shocks could
Wide Complex Tachycardia
Wide complex tachycardia is identified on an ECG by a heart rate over 100 bpm and a QRS duration over 0.12 seconds for at least 3 consecutive beats. The ACC/AHA/ESC guideline proposes an algorithm for differentiating types of wide complex tachycardia using ECG patterns. This includes algorithms from the Brugada working group to distinguish ventricular tachycardia from pre-excited tachycardia, and the aVR Vereckei algorithm which analyzes the velocity ratio between initial and terminal portions of the QRS complex in lead aVR to identify ventricular tachycardia or supraventricular tachycardia.
Basic Ecg
This document provides an overview of electrocardiography (ECG or EKG) for paramedics. It defines an ECG as a method for measuring, displaying, and recording the electrical activity of the heart. The key components of an ECG are identified as the P wave, PR interval, QRS complex, ST segment, T wave, and QT interval. The document outlines the normal values and appearances of these components and describes how to evaluate an ECG strip by examining rate, rhythm, sequence of waves, duration, distances, and configurations. Abnormal findings are also discussed.
Vt vs svt ab copy
The document discusses various electrocardiogram (ECG) criteria for differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with aberrancy presenting with a wide QRS complex tachycardia. It outlines criteria from Sandler and Marriott (1965), Wellens (1978), Kindwall (1988), Brugada (1991), Vereckei (2008) and Pava (2010). Key criteria that favor VT include QRS duration >140ms, extreme left axis, AV dissociation, monophasic R wave in V1, R/S ratio <1 in V6, and notching of the S wave in V1.
Basic of ecg interpretation
The document provides an overview of electrocardiogram (ECG or EKG) interpretation. It discusses cardiac anatomy and physiology relevant to understanding ECGs. The basics of the 12-lead ECG system are explained, including the six limb leads and six precordial leads. Components of the ECG waveform like the P, QRS, and T waves are defined. An 8-step method for ECG interpretation is outlined, beginning with analyzing the rhythm and rate, and then evaluating each waveform and interval. Key points include determining normal durations for the P wave, PR interval, QRS complex, QT interval, and identifying abnormalities. The summary restates normal findings for a sinus rhythm ECG.
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This document provides an overview of ECG samples and diagnosis for medical students. It discusses the basics of ECG interpretation, normal sinus rhythm, intervals, waveforms, abnormalities, myocardial infarction, bundle branch blocks, ventricular hypertrophy, atrial fibrillation, and more. Examples of various abnormal ECG patterns are presented along with explanations. Sources include textbooks and online resources for ECG learning. The document is intended for educational presentation purposes.
ECGpedia - ECG Presentation
The document outlines a systematic 7+2 step approach for interpreting electrocardiograms (ECGs) that involves analyzing the rhythm, rate, conduction, axes, wave morphologies, segment changes, and comparing to previous ECGs to form a clinical conclusion. The 7 steps examine the rhythm, rate, conduction intervals, axes, P wave, QRS, and ST-T wave morphologies. The +2 steps involve comparing the ECG to previous tracings and formulating a concluding statement.
WCT
1. Wide complex tachycardia (WCT) refers to tachycardias with a heart rate over 100 beats per minute and a QRS duration greater than 0.12 seconds.
2. WCT can be caused by irregular rhythms like atrial fibrillation or regular rhythms like supraventricular tachycardia with aberrant conduction or ventricular tachycardia.
3. Management depends on hemodynamic stability and rhythm characteristics - synchronized cardioversion is first-line for unstable patients, while antiarrhythmic drugs or pacing are used for stable patients depending on the underlying rhythm.
Wide complex tacycardia
Wide QRS tachycardia requires differentiating between ventricular tachycardia (VT) and supraventricular tachycardia (SVT) with aberrancy. The document outlines the following approach:
1. Obtain history, physical exam, and 12-lead electrocardiogram (ECG) findings to help determine VT vs SVT. Features like AV dissociation or axis deviation favor VT.
2. Use criteria/algorithms like Wellens, Brugada, Vereckei (incorporating lead aVR) to analyze ECG morphology. A majority of criteria must be met to diagnose VT.
3. Consider electrophysiological testing like measuring His-ventricular intervals
An ECG workshop
This document provides an overview of an ECG workshop that aims to teach the anatomy and physiology of the heart, understanding ECGs, ischaemia and myocardial infarction, caring for cardiac patients, and case studies. It covers topics like the anatomy of the heart chambers and coronary arteries, electrical conduction system, understanding ECG lead placement and components of the PQRST complex, identifying abnormalities like ischemia, infarction locations and evolutions, and care of the cardiac patient.
ECG BASICS AND ARRTHYMIAS
ECG BASICS AND ARRTHYMIAS -
-Dr Prudhvi Krishna
,
basics of ecg
,
basicsecg
,
ecg
,
arrthymias
Case-Based ECG
The document outlines the 10 step approach to interpreting electrocardiograms (ECGs) and presents two case studies from remote Aboriginal communities. It details the steps of an ECG including assessing the rate, rhythm, waves, intervals, segments, and complexes. The first case involves a 10 year old girl named Thomasina presenting with jerky movements and fever, who is diagnosed with rheumatic fever based on her ECG and blood tests. The second case describes a pilot named Frank who develops palpitations and is found to be in supraventricular tachycardia based on his ECG, which is terminated with carotid sinus massage.
ECG: Atrial Infarct
A 65-year-old man presented with chest discomfort and other symptoms. His ECG showed sinus rhythm with ST elevations and PR interval prolongation. The findings were consistent with an inferoposterior wall myocardial infarction as well as right atrial infarction, likely due to proximal right coronary artery occlusion. Atrial infarction can occur in up to 25% of STEMI cases but is often clinically unrecognized due to its subtle ECG changes such as P-Ta segment elevations. Complications of atrial infarction include arrhythmias and thromboembolism.
12 lead introduction review of the basics
The 12-lead ECG provides 12 pictures of the heart that can be interpreted in under 60 seconds. There are 3 limb leads, 3 augmented limb leads, and 6 precordial leads that each represent a different view of the heart. Understanding the vector, or direction of electrical flow, of each lead helps identify abnormalities in cardiac depolarization. The mean QRS axis can be determined from leads I, II, and III and indicates the quadrant of cardiac electrical activity. Interpreting 12-lead ECGs involves recognizing common patterns that indicate conditions like myocardial infarction.
Rhythm recognition
This document provides an overview of rhythm recognition and interpretation from an electrocardiogram (ECG). It defines common ECG components like the P wave, QRS complex, and T wave. It identifies normal sinus rhythm and discusses other rhythms like sinus bradycardia, sinus tachycardia, premature ventricular contractions, ventricular fibrillation, ventricular tachycardia, and asystole. The document provides guidance on lead placement, intervals, and measuring heart rate from an ECG. It emphasizes the importance of maintaining patient dignity and monitoring vital signs in addition to the ECG.
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This document provides an overview of ECG interpretation presented by Dr. Raghoba. It outlines the normal ECG components and measurements. It then describes various arrhythmias including tachycardias like sinus tachycardia, atrial fibrillation and ventricular tachycardia. Bradycardias like sinus bradycardia and heart block are also reviewed. Common ECG findings for myocardial infarction, bundle branch blocks, ectopics and structural heart disease are presented. Electrolyte disturbances and other miscellaneous ECG patterns are also discussed.
Method of ECG Interpretation
This document outlines a standardized method for interpreting 12-lead electrocardiograms (ECGs). The method involves analyzing six major sections in a specific order: heart rate, PR interval, QRS duration, QT interval, QRS axis, and waveforms. Each section is analyzed to identify any abnormalities, including intervals outside normal ranges or irregular waveforms. After following this method, the interpreter provides an overall interpretation of the ECG as normal or abnormal, listing any findings.
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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 #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.
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.
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.
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.
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.
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 - #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.
Stepwise interpretation of ECG - #12 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 rhythm was originating from the AV junction. The final diagnosis was sinus rhythm with complete heart block and an escape junctional rhythm at a ventricular rate of 43/min.
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 - #12 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.
More from Anas Nader (20)
ID 352 –Sinus rhythm With premature atrial complex
ID 352 –Sinus rhythm With premature atrial complex
Stepwise interpretation of ECG ID123
- 1. ID 123 – 67 year old woman complaining of palpitation
- 2. ID 123 – 67 year old woman complaining of palpitation The patient has a narrow-QRS tachycardia (160/min) – Can your see P waves?
- 3. ID 123 – 67 year old woman complaining of palpitation If your answer was yes , go to the next slide, if it was no , look again and then go ahead
- 4. ID 123 – Atrial tachycardia, 160/min P waves precede the QRS complexes. They are negative in II, III, aVF and V3-V6. The PR interval is 140 msec. The arrhythmia is Atrial Tachycardia.
- 5. ID 123 – Final diagnosis: Atrial tachycardia, 160/min The QRS axis is normal. The QRS duration is 80 msec. There is no ventricular hypertrophy. No signs of infarction. T waves are seen in I, aVL and V4-V6 and appear normal.