Interpreting ECG – the Quickest Way

Here is a quick 13 MUST POINT to analyse in reading ECG Quickly

Check for normal standardisation & calibration first
Normal Speed 25mm/sec & 1mV = 10mm deflection


Heart Rate Calculation
Bradycardia – <60 bpm
Tachycardia – >100 bpm

Rhythm
Regular Rhythm – Equal R-R Interval

Irregular Rhythm

Unequal R-R Interval
Unequal R-R Interval – Irregular Rhythm

 

P-R Interval

P Wave Amplitude & Width

QRS Width

Normal QRS Width = <3 Small Squares [0.10 sec]

QT Interval

QT interval depends on Heart Rate & so RR Interval
Increased RR Interval increases QT Interval & same with decreased condition.
Corrected QT = QTc = QT/√RR
Normal Range 0.33 – 0.44 sec

R Wave Progression in Chest Leads


d/d- ?Lead placement ?Anteroseptal or anterior wall myocardial infarction ?Left ventricular hypertrophy ?Left anterior fascicular block ?Chronic Lung Disease

abnormal Q wave

Prominent Q Waves in Rest of the leads – Anterior MI

ST Segments & T Wave


U Wave
U waves are best seen in lead V3

QRS Axis & Voltage



To calculate axis, see the deviation of Lead I &  AVF,  + or

Interpretation
Final ECG report consists of

  1. Rate / PR-QRS-QT / QTc Interval / QRS Axis
  2. Rhythm / AV Conduction
  3. Key Findings
  4. Inferences / Implications

Every ECG Abnormality should list the possible differential diagnosis

 


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