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↪ ECG Basics Homepage The PR segment is the flat, usually isoelectric segment between the end of the P wave and the start of the QRS complex. PR segment abnormalities These occur in two main conditions: Pericarditis Atrial ischaemia Pericarditis The characteristic changes of acute pericarditis are: PR segment depression. Widespread concave (‘saddle-shaped’) ST elevation. Reciprocal ST depression and PR elevation in aVR and V1 Absence of reciprocal ST depression elsewhere. NB. PR segment changes are relative to the baseline formed by the T-P segment. ...

↪ ECG Basics Homepage R wave Overview The R wave is the first upward deflection after the P wave. The R wave represents early ventricular depolarisation Abnormalities of the R wave There are three key R wave abnormalities: Dominant R wave in V1 Dominant R wave in aVR Poor R wave progression 1. Dominant R wave in V1 Causes of Dominant R wave in V1 Normal in children and young adults Right Ventricular Hypertrophy (RVH) Pulmonary Embolus Persistence of infantile pattern Left to right shunt Right Bundle Branch Block (RBBB) Posterior Myocardial Infarction (ST elevation in Leads V7, V8, V9) Wolff-Parkinson-White (WPW) Type A Incorrect lead placement (e.g. V1 and V3 reversed) Dextrocardia Hypertrophic cardiomyopathy Dystrophy Myotonic dystrophy Duchenne Muscular dystrophy Examples of Dominant R wave in V1 Normal paediatric ECG (2 yr old) ...

aka ECG Interpretation Made Easy One day, in a town not too far from here, the ICU registrar (you) is admitting a 60 year old male, who has just been brought into the emergency department with profound weakness, and needed to be intubated for respiratory failure. They were struggling in the ER, all resuscitation bays were full, and ambulances are backing up outside. No lab tests are back and they hadn’t even done an ECG. You sigh, and agree to take the patient against your better judgement… ...

Part three of a 5 part lecture series on ECG/EKG Interpretation on conduction disease with Dr Theo Sklavos and cardiologist A/Prof William Wang. This lecture series is aimed primarily at medical/nursing/paramedicine students and junior trainees, but will hopefully be useful as a refresher course for those with previous experience. Conduction disease Identify AV nodal block, bundle branch and fascicular blocks. Identify escape rhythms and their origin. ECG Interpretation lectures The Basics Myocardial ischemia and infarction Conduction disease Tachyarrhythmia Other cardiac conditions References and further reading Left anterior fascicular block Left posterior fascicular block Bifascicular block – Trifascicular block Left bundle branch block (LBBB) Right bundle branch block (RBBB) AV block: 1st degree AV block: 2nd degree, Mobitz I (Wenckebach) AV block: 2nd degree, Mobitz II (Hay) AV block: 2nd degree, “fixed ratio blocks” (2:1, 3:1) AV block: 2nd degree, “high grade AV block” AV block: 3rd degree (complete heart block) ECG Resources/References ECG LIBRARY ...

Part two of a 5 part lecture series on ECG/EKG Interpretation – Myocardial ischemia and infarction – with Dr Theo Sklavos and cardiologist A/Prof William Wang. This lecture series is aimed primarily at medical/nursing/paramedicine students and junior trainees, but will hopefully be useful as a refresher course for the more experienced. Myocardial ischaemia and infarction Identify the signs of myocardial ischaemia on the ECG. Identify which region of myocardium is ischaemic. Identify posterior infarction, right ventricular infarction, ischaemia in paced rhythms and LBBB. ECG Interpretation lectures The Basics Myocardial ischemia and infarction Conduction disease Tachyarrhythmia Other cardiac conditions References and further reading Myocardial ischemia Posterior Myocardial Infarction Right Ventricular Infarction ECG Resources/References ECG LIBRARY ...

Part four of a 5 part lecture series on ECG/EKG Interpretation on tachyarrhythmias with Dr Theo Sklavos and cardiologist A/Prof William Wang. This lecture series is aimed primarily at medical/nursing/paramedicine students and junior trainees, but will hopefully be useful as a refresher course for the more experienced. Tachyarrhythmia Identify the common types of tachycardia. Split into wide vs narrow complex. ECG Interpretation lectures The Basics Myocardial ischemia and infarction Conduction disease Tachyarrhythmias Other cardiac conditions References and further reading Supraventricular tachycardia (SVT) Ventricular tachycardia Right Ventricular Outflow Tract (RVOT) tachycardia VT versus SVT with aberrancy AVNRT (AV-nodal re-entry tachycardia) AVRT (atrioventricular re-entry tachycardia) Wolff-Parkinson White Syndrome ECG Resources/References ECG LIBRARY ...

↪ ECG Basics Homepage Who is SAM? As a routine part of ECG analysis, we need to determine the ECG AXIS. It isn’t really enough to just whimper… “Is it normal?” So, to help understand axis a tiny bit…I need to introduce you to SAM – the Super Axis Man Building SAM – the Super Axis Man (1) Draw a circle and put SAMs head on the top. Note: SAM is smiling today because he is learning something… ...