EKG ...what u look for

EKG MASTER CLASS 2014: INTERPRETATION OF AN EKG:

What do you look for in an EKG?

1. VALIDITY : Name on EKG
Indication for EKG
Mirroring of Lead I and Lead aVR
“R” Wave progression in precordial Leads

2. RHYTHM: Sinus or not, P present or not If P present sinus origin P or not
P married to QRS or not

3. RATE: Regular or not
If irregular, pattern
Same rate or variable rate

4. AXIS: Vertical axis normal. Left or right or intermittent Horizontal axis same as before or now more clockwise or less

5. INTERVAL: PR normal, short or long
RR constant or increasing
QT normal or long

6. HYPERTROPHY: P waves tall, wide, bifid or normal
Voltage criteria for RVH and LVH met or not

7. CONDUCTION : Normal QRS duration in V1 –V2 or not
Normal QRS duration in V5-V6 or not
Axis & hypertrophy compatible or not ,else should look for Hemi block .

8. PERFUSION: Ischemia or not (T Inversion)
Injury or not ( ST depression)
Infarction or not (ST elevation or q)
Infarction old or new
LBBB with infarction or not

9. SEGMENTS : Baseline stable or not
PR depressed or not
ST reflecting perfusion or something else

10. EXTRA FINDINGS: RR Prime or Osborne waves
Delta waves or IVCD
CEREBRAL T waves or T inversion etc,...

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