EKG Interpretations, Schemes and Mind Maps of Cardiology

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EKG Interpretations

Chad Link, DO FACC Cardiologist Chairman Cardiology Section Sparrow TCI Lansing, MI

Disclosures

EKG

EKG – 12 Leads

• Anterior Leads - V1, V2, V3, V
• Inferior Leads – II, III, aVF
• Left Lateral Leads – I, aVL, V5, V
• Right Leads – aVR, V

11 Step Method for Reading EKG’s

• “Diagnoses”
  • 5. Rhythm
  • 6. Atrioventricular (AV) Block
  • 7. Bundle Branch Block or Hemiblock
  • 8. Preexcitation
  • 9. Enlargement and Hypertrophy
  • 10. Coronary Artery Disease
  • 11. Utter Confusion » The Only EKG Book You’ll Ever Need Malcolm S. Thaler, MD Cardiology/EKG Board Review- MJ Bradley, DO

Heart Rate

• Regular Rhythms

Intervals

• Measure length of PR interval, QT interval, width of P wave, QRS complex

QTc

• QTc = QT interval corrected for heart rate
  • Uses Bazett’s Formula or Fridericia’s Formula
• Long QT syndrome – inherited or acquired (>75 meds); torsades de pointes/VF; syncope, seizures, sudden death

Rhythm

• 4 Questions
  • 1. Are normal P waves present?
  • 2. Are QRS complexes narrow or wide (≤ or ≥ 0.12)?
  • 3. What is relationship between P waves and QRS complexes?
  • 4. Is rhythm regular or irregular?
• Sinus rhythm = normal P waves, narrow QRS complexes, 1 P wave to every 1 QRS complex, and regular rhythm

Types of Arrhythmias

• Arrhythmias of sinus origin
• Ectopic rhythms
• Conduction Blocks
• Preexcitation syndromes

Bundle Branch Blocks

• Diagnosed by looking at width and configuration of QRS complexes

Bundle Branch Blocks

Hemiblocks

• Diagnosed by looking at right or left axis deviation
• Left Anterior Hemiblock
  • 1.Normal QRS duration and no ST segment or T wave changes
  • 2. Left axis deviation greater than - 30 °
  • 3. No other cause of left axis deviation is present
• Left Posterior Hemiblock
  • 1. Normal QRS duration and no ST segment or T wave changes
  • 2. Right axis deviation
  • 3. No other cause of right axis deviation is present