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    EKG Curs Asistenti Medicali Generalistri

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    Diana Ioana
    This document provides an overview of how to interpret different components of an electrocardiogram (ECG) including: [1] identifying the rhythm as sinus, atrial fibrillation, or ventricular tachycardia; [2] measuring the heart rate; [3] analyzing the axis; [4] examining the morphology for conditions like sinus rhythm, atrial flutter, bundle branch blocks, and myocardial infarctions. Examples are given of common arrhythmias and how to recognize them based on features of the ECG like the presence or absence of P waves, QRS width, and ST segment changes.

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    EKG Curs Asistenti Medicali Generalistri

    Uploaded by

    Diana Ioana
    146 views18 pages
    This document provides an overview of how to interpret different components of an electrocardiogram (ECG) including: [1] identifying the rhythm as sinus, atrial fibrillation, or ventricular tachycardia; [2] measuring the heart rate; [3] analyzing the axis; [4] examining the morphology for conditions like sinus rhythm, atrial flutter, bundle branch blocks, and myocardial infarctions. Examples are given of common arrhythmias and how to recognize them based on features of the ECG like the presence or absence of P waves, QRS width, and ST segment changes.

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    EKG Curs Asistenti medicali generalistri

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    EKG Curs Asistenti medicali generalistri

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    This document provides an overview of how to interpret different components of an electrocardiogram (ECG) including: [1] identifying the rhythm as sinus, atrial fibrillation, or ventricular tachycardia; [2] measuring the heart rate; [3] analyzing the axis; [4] examining the morphology for conditions like sinus rhythm, atrial flutter, bundle branch blocks, and myocardial infarctions. Examples are given of common arrhythmias and how to recognize them based on features of the ECG like the presence or absence of P waves, QRS width, and ST segment changes.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Download as pdf or txt
    146 views18 pages

    EKG Curs Asistenti Medicali Generalistri

    Uploaded by

    Diana Ioana
    This document provides an overview of how to interpret different components of an electrocardiogram (ECG) including: [1] identifying the rhythm as sinus, atrial fibrillation, or ventricular tachycardia; [2] measuring the heart rate; [3] analyzing the axis; [4] examining the morphology for conditions like sinus rhythm, atrial flutter, bundle branch blocks, and myocardial infarctions. Examples are given of common arrhythmias and how to recognize them based on features of the ECG like the presence or absence of P waves, QRS width, and ST segment changes.

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    of 18

    ECG

    Dr. Dragoș Marcu


    1) RHYTHM: is it sinus rhythm? AFiB? AFlutter?
    2) HEART RATE: 300-150-100-75-60-50-40…rule
    1st 300 150 100 75 60…so, a HR of 60 bpm

    3) AXIS: DI, aVF “thumbs up” – normal axis [-30;+120]


    Positive QRS in DI

    Positive QRS in aVF

    4) MORPHOLOGY and diagnosis


    P wave present
    → sinus rhythm

    Normal morphology

    Positive QRS in DI,


    aVF → normal axis

    Slight bradicardia → normal


    aspect for athlets

    Normal EKG
    No P wave, but we see “sawtooth” F
    waves → atrial flutter

    Usually you can see a regular rhythm!

    Atrial Flutter
    No P wave, but we small f waves →
    atrial fibrillation

    Usually you can see an iregular rhythm!

    Atrial Fibrillation
    B.M. Glover, P. Brugada, Clinical handbook of cardiac electrophysiology, 2016, Springer

    Ventricular Tachycardia
    RBBB morphology → origin
    Wide QRS
    from the left ventricle

    Positive QRS in
    aVR → very
    specific for VT

    Treat ALL wide-complex


    Regular rhythm and
    tachyarrhythmias as VT in an
    identical complexes
    emergency setting!!!

    Monomorphic Ventricular Tachycardia


    The axis keeps “twisting” around the
    baseline…from here the name of “TORSADES
    DE POINTES” (yeah, it’s French… ^-^) Wide QRS

    Iregular rhythm and


    non-identical complexes

    Polymorphic Ventricular Tachycardia


    Iregular rhythm and non-identical small
    complexes – totally unorganized rhythm

    Ventricular Fibrillation
    Prolonged and fixed PR (>200 ms) but
    NO dropped QRS!

    1st degree AVB


    Progressively prolonging PR

    P not followed by a
    QRS → dropped QRS

    Monitor recording of the


    same lead on multiple
    channels 2nd degree AVB type 1
    P P → dropped QRS

    On this ECG we have a 2:1 ratio

    Also…a concomitant LBBB on


    this ECG

    2nd degree AVB type 2 2:1


    P P P P P

    P-P P-P P-P

    R-R R-R R-R

    No relationship between the P waves and the QRS complexes

    3rd degree AVB


    QRS complex wider than 120 ms
    Wide positive QRS in V5-V6

    LBBB
    QRS complex wider than 120 ms
    M shape of QRS in V1-V2

    RBBB
    Myocardial infarction

    1) ANTERIOR: V1-V4
    2) LATERAL: DI, aVL, V5, V6
    3) EXTENSIVE ANTERIOR: V1-V6,
    4) INFERIOR: DII, DIII, aVF
    5) POSTERIOR: V7, V8, V9
    6) RIGHT VENTRICLE: V3R, V4R, V5R
    ST depression (mirror
    image from the
    posterior leads…)

    ST elevation

    ST elevation

    Postero-inferior STEMI
    ST elevation

    Anterior STEMI

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