28 Jul Steps to understand ECG Interpretation
ECGs Made Easy?
We imagine it is understood that learning all of ECG interpretation is going to take more than 10 minutes of your time and that it is not quite so easy. To be proficient, it will take a bit of effort. Some memorization and pattern recognition will be required. The more you see, the more you will remember. Having a pair of calipers is helpful. Now that this is understood, let’s get down to it.
Learn the Basics ECG Tracing
First things first. Knowing the basic parts of an ECG tracing will lay a good foundation for everything else that is to come. The different waves, complexes and intervals need to be ingrained in your brain. How many seconds is a full ECG tracing? How much time does each big box and each little box represent?
This is not the time to learn the crazy things such as the different P-wave morphologies that occur with atrial enlargements and ectopic atrial rhythms but rather, just to know what the normal P wave looks like and what it represents. It’s a similar concept for the other parts of the ECG.
Determine Heart Rate on the ECG
To determine whether bradycardia, a normal heart rate or tachycardia is present requires the knowledge to calculate the heart rate on the ECG. Remember to apply these techniques to both the atrial rate, measured by the rate of the P wave, and the ventricular rate, measured by the rate of the QRS complex.
Determine Axis on the ECG
The axis on the ECG can give a clue to many different pathologic states. Unless you are going into electrophysiology as a career, the only axis that you need to measure is that of the QRS complex. Be sure to know the causes of left axis deviation, right axis deviation and when the axis is indeterminate (northwestern). Also, know the quick shortcuts to determine the axis.
Learn Abnormal Heart Rhythms
Sometimes this can be the most difficult part. Atrial enlargements are not too bad, but the criteria for left ventricular hypertrophy can drive you crazy. No need to memorize then all, just the main two or three. Left and right bundle branch are not too bad, either. The “bunny ears” are easy to spot in right bundle branch blocks though not always present. Don’t forget to learn what a non-specific interventricular conduction delay looks like, as well.
Learn Acute MI and Ischemic ECG Findings
This is the fun part of ECG interpretation. Some of the acute MI ECG findings, such as anterior ST segment elevations and inferior ST segment elevation MIs, are obvious. The tough part is identifying the more subtle ECG changes.
Know when ST segment elevation is due to ischemia and when it is due to other causes including left ventricular aneurysm or left ventricular hypertrophy. Likewise, know when ST segment depression is due to digoxin ECG changes.
Review ECGs in Real Patient Case Scenarios
Whether you are a medical student in clinical rotations, an EMT or an internist in practice, looking at the ECGs that you encounter in practice is important. See how the ECG fits the clinical scenario. Sometimes the best way to remember an ECG finding is to associate it with an interesting case that you experienced personally.
This article is only or information purposes to develop your understanding of ECG. Always consult a doctor to check your ECH results. Call the HeartAid Centre for appointments with our cardiologists. The Non-hospital environment at HeartAid Centre the minimizes the risk of cross infection and spread of Covid-19. Please Contact: 0114-504662/3