Welcome to my first blog post! Today's post is on ECG interpretation and i'm taking it back to basics for undergraduates and trying to highlight what you NEED to know! We're going to cover the 6 essential areas to cover before exploring tachyarrythmias and bundle branch block.
The 6 key points in any ECG interpretation
1) Rate 300/Big boxes or Count the complexes and multiply by 6
2) Rhythm Regular or Irregular
3) P waves Present? Preceding every QRS?
4) QRS Narrow or Broad ( < or > 3 small boxes?)
5) ST segments Elevation or Depression?
6) T waves Inversion?
From this we can advance it up to include axis deviation and LV hypertrophy. Axis deviation can be calculated simply and there is no need at an undergraduate level for funny complicated triangle drawing with degress written all over them.
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| Over Complicated |
Left Axis = I and III LEAVING each other
Right Axis = I and III REACHING each other
LVH = Biggest R + S waves in the V leads if >7 big boxes then there is LVH
Next up we covered the classification of Tachyarrythmias. In simple terms broad QRS means it is ventricular and narrow QRS means it is atrial.
We touched briefly on Bundle Branch Block and the worldwide use of WiLLaM and MaRRoW. Looking at lead V1 and V6 for the M or W.
Examples of all the ECGs and sections covered above and more can be found in the presentation - ECG Presentation and below are a few ECGS to think over before the next blog.
A big thank you to LITFL for the having such an extensive ECG library
Feel free to post any comments on anything you disagree with or any suggestions for what else could be included or emphasised in a 1 hour ECG tutorial.
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