12-lead ekg interpretation -...
TRANSCRIPT
![Page 1: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/1.jpg)
12-Lead EKG Interpretation
Judith M. Haluka BS, RCIS, EMT-P
![Page 2: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/2.jpg)
ECG Grid• Left to Right = Time/duration• Vertical – measure of voltage (amplitude)
– Expressed in mm
![Page 3: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/3.jpg)
P-Wave
• Depolarization of atrial muscle• Low voltage (2-3mm in amplitude)• Duration <.11 seconds
![Page 4: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/4.jpg)
Abnormal P Waves
• P – Pulmonale– Tall Peaked– Right atrial enlargement secondary to
pulmonary HTN (COPD)
• P-Mitrale– Broad notched– LA enlargement secondary to mitral valve
disease
![Page 5: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/5.jpg)
![Page 6: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/6.jpg)
P-wave Abnormalities
• Wolfe – Parkinson-White– Ventricles activated early– Short PR Interval– Delta Wave
![Page 7: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/7.jpg)
![Page 8: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/8.jpg)
QRS Complex
• Depolarization of ventricles• Larger Muscle Mass• Amplitude as high as 25mm• Duration with Normal Conduction <.10• Amplitudes >25mm can mean chamber
enlargement as in ventricular hypertrophy
![Page 9: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/9.jpg)
QRS Complex
• Low Amplitude– Diffuse, severe coronary artery disease– Pericardial Effusion– Hypothyroid
![Page 10: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/10.jpg)
QRS Complex
• 1st Negative deflection = Q Wave• 1st Positive deflection = R wave• Negative deflection after R wave = S wave• Positive deflection after R wave = R Prime• Negative deflection after S wave = S Prime
![Page 11: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/11.jpg)
![Page 12: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/12.jpg)
ST Segment
• Time between completion of depolarization and onset of repolarization– Normally isoelectric & gently blends into
upslope of T wave– Point where ST takes off from QRS= J point
• Plays important role in diagnosis of ischemic heart disease
![Page 13: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/13.jpg)
ST Segment
• ST Elevation = hallmark of AMI• Slight elevation across entire tracing is
normal especially in young males• ST DEPRESSION – indicative of a # of
conditions . . . Ischemia, ventricular hypertrophy
![Page 14: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/14.jpg)
T - Wave
• Repolarization of the ventricles• Same direction as predominant QRS
deflection• Abnormalities – usually inversion with
BBB, hypertrophy or AMI
![Page 15: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/15.jpg)
QT Interval
• Beginning of QRS to end of T Wave• Normal variations with HR and gender• Abnormalities
– Prolonged – commonly from drugs like Procan or Quinidine or electrolyte imbalance
– Increased opportunity for R on T, ventricular re-entry rhythms and sudden death
![Page 16: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/16.jpg)
Vectors and Lead Systems
• Arrows represent direction as well as amplitude
![Page 17: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/17.jpg)
Vectors
• Vector 1 – depolarization of atrial (corresponds to P wave)
• Vector 2 – Ventricular Septum (1st
deflection of QRS)• Vector 3 – Bulk of ventricular muscle• Vector 4 – Repolarization of ventricular
muscle
![Page 18: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/18.jpg)
![Page 19: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/19.jpg)
Limb Leads
• Look at heart in Frontal Planes• Used to locate axis• V Leads look at heart in Transverse Plane
![Page 20: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/20.jpg)
Lead Placement
• Correct placement a must• Small changes in height of R wave are
important• Can be produced with slight movement of
leads
![Page 21: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/21.jpg)
Lead Placement
• V1 – Right Sternal Border – 4th ICS• V2 – Left Sternal Border – 4th ICS• V3 Midway Between V2 and V4• V4 Midclavicular line – 5th ICS• V5 Anterior Axillary line – 5th ICS• V6 Mid axillary line – 5th ICS
![Page 22: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/22.jpg)
![Page 23: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/23.jpg)
Determining Axis
• Impulse toward electrode = Positive• Impulse away from electrode = Negative• The more directly toward or away the
greater the amplitude either positive or negative
![Page 24: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/24.jpg)
![Page 25: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/25.jpg)
Axis Deviation
• Normal Axis = 60 Degrees (0-90)• Further counter clockwise than 0 = Left
Axis Deviation• Further clockwise than 90 = Right Axis
Deviation• > -30 Marked LAD• >-120 Marked RAD
![Page 26: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/26.jpg)
![Page 27: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/27.jpg)
Axis Deviation
• Determined by Tallest R Wave– Normal is Lead II
• PVC’s or VT from Right Ventricle = LAD• PVC’s or VT from Left Ventricle = RAD
![Page 28: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/28.jpg)
![Page 29: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/29.jpg)
R-Wave Progression
• V1 is small – progressively increasing from right to left until QRS fully upright in V5 and V6
• Point where QRS becomes biphasic = transition zone
• R wave progression is frequently lost in Anterior Wall Infarction
![Page 30: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/30.jpg)
![Page 31: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/31.jpg)
![Page 32: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/32.jpg)
Bundle Branch Blocks
• Incomplete – Conducts slowly– QRS between .10 and .12
• Complete – Total failure of affected bundle to conduct impulse– QRS >.12
![Page 33: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/33.jpg)
Bundle Branch Blocks
• Right Bundle Branch Blocks– Reverse normal pattern of negative QRS in V1– RSR in V1– Wide S wave in V5 and V6
![Page 34: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/34.jpg)
![Page 35: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/35.jpg)
Left Bundle Branch Block
• RSR in V5 and V6• Deep negative QS in V1 and V2• Causes Widespread ST Changes• Non-Diagnostic for ischemia and infarction
![Page 36: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/36.jpg)
![Page 37: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/37.jpg)
![Page 38: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/38.jpg)
![Page 39: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/39.jpg)
Myocardial Infarction
![Page 40: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/40.jpg)
Coronary Anatomy
![Page 41: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/41.jpg)
Myocardial Infarction
• Usually result of clot formation at site of fixed lesion
![Page 42: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/42.jpg)
Hallmark of Infarction
• Transmural – full thickness of myocardial wall– ST Elevation– T Wave Inversion– Q Wave Formation
![Page 43: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/43.jpg)
![Page 44: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/44.jpg)
Inferior Wall Infarction
• Leads II, III and aVF• Reciprocal Changes in Anterior Wall• Most common Presentation is Bradycardia• Can be associated with RV Infarction
![Page 45: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/45.jpg)
![Page 46: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/46.jpg)
Old Inferior Wall MI
![Page 47: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/47.jpg)
Anterior Wall Infarction
• V2, V3 through V4• Loss of R Wave progression• Reciprocal Depression in leads of inferior
wall
![Page 48: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/48.jpg)
![Page 49: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/49.jpg)
![Page 50: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/50.jpg)
![Page 51: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/51.jpg)
Lateral Wall
• I and aVL• V5 and V6• Usually associated with another infarction
![Page 52: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/52.jpg)
ST Elevation
• QRS Dos not return to baseline (J-point)• 2 or more leads looking at the same wall• Acute Event
![Page 53: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/53.jpg)
T Wave Inversion
• Frequently bi-phasic• Same leads as ST elevation• Still in “process of infarcting”
![Page 54: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/54.jpg)
Q Wave
• Ceases to depolarize• Essentially electrically inert• Permanent
![Page 55: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/55.jpg)
![Page 56: 12-Lead EKG Interpretation - c.ymcdn.comc.ymcdn.com/.../resource/resmgr/docs/12-lead_ekg_interpretation.pdfECG Grid • Left to Right = Time/duration • Vertical – measure of voltage](https://reader031.vdocuments.mx/reader031/viewer/2022030407/5a84531b7f8b9a9f1b8ba68b/html5/thumbnails/56.jpg)
Sneaky Causes of ST Elevation
• PERICARDITIS– Widespread– No reciprocal changes– PR Segment Depression