ECG interpretation

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  • Created by: z
  • Created on: 04-03-16 18:31

10 steps of evaluating an ECG

1.       Patient demographics

2.       Rate

3.       Rhythm

4.       Axis

5.       P wave

6.       PR interval

7.       QRS complex

8.       ST segment

9.       T wave

10.   QT interval

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Rate and rhythm

  • Rate
    • Normal is 60-100bpm
    •  Workout as 300/(large squares b/w QRS complex)
  • Rhythm
    • Regular/irregular?
    •  Use piece of paper to compare distance b/w R-R intervals
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Axis

  • Normal is between -30o and +90o
  •  < -30o = left axis deviation
  •   > +90o = right angle deviation
  •  Between 180o and -90o = far RAD or far LAD (“Northwest”)
  •  Identifying the axis:
    • Identify most isoelectric lead (i.e. w/ flattest QRS)
    • Axis is at 90o to this
    • If deflection is positive
  • NB quick method – if I and II are positive= normal
    • If “reaching” towards = RAD
    • If “leaning” away = LA
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Parts of the ECG

  • P wave
    • P wave = atrial depolarisation
  • PR interval
    • PR interval = AV delay
    • Normal = 0.12-0.2s
  • QRS
    • QRS complex = ventricular depolarisation (down BoH then up PF)
    • Normal <0.12s
  • ST segment
    • Time b/w end of depol and start of repol
    • Should be isoelectric
  • T wave
    • Ventricular repolarisation
    • Normal to be inverted in aVR, V1, sometimes V2
  • QT interval
    • From beginning of QRS to end of T wave
    • Normal is 0.38-0.42s
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