The ECG Made Easy

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The paper used to record ECGs is standardised across most hospitals and has the following characteristics:

ECG Made Easier • LITFL • ECG library - Life in the Fast Lane ECG Made Easier • LITFL • ECG library - Life in the Fast Lane

RAD is commonly associated with conditions such as pulmonary hypertension, as they cause right ventricular hypertrophy. RAD can, however, be a normal finding in very tall individuals. Right Axis Deviation Left axis deviation Right axis deviation (RAD) involves the direction of depolarisation being distorted to the right (between +90º and +180º). The mythical ‘ delta wave‘ indicates that the ventricles are being activated earlier than normal from a point distant from the AV node. The early activation then spreads slowly across the myocardium, causing the QRS complex’s slurred upstroke. A narrow QRS complex occurs when the impulse is conducted down the bundle of His and the Purkinje fibre to the ventricles. This results in well organised synchronised ventricular depolarisation. Whenever the direction of electrical activity moves away from a lead, a negative deflection is produced.If the R and S waves are of equal size, it means depolarisation is travelling at exactly 90° to that lead.

The ECG Made Easy - 9th Edition - Elsevier The ECG Made Easy - 9th Edition - Elsevier

When the electrical activity within the heart travels away from a lead, you get a negative deflection. The data gathered from these electrodes allows the 12 leads of the ECG to be calculated (e.g. lead I is calculated using data from the electrodes on both the right and left arm).

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ST-elevation is significant when it is greater than 1 mm (1 small square) in 2 or more contiguous limb leads or >2mm in 2 or more chest leads.

Understanding an ECG | ECG Interpretation | Geeky Medics Understanding an ECG | ECG Interpretation | Geeky Medics

Benign early repolarisation occurs mostly under the age of 50 (over the age of 50, ischaemia is more common and should be suspected first). These become larger the slower the bradycardia – classically U waves are seen in various electrolyte imbalances, hypothermia and secondary to antiarrhythmic therapy (such as digoxin, procainamide or amiodarone). U waveA new opening chapter entitled ‘ The ECG made very easy’ distils the bare essentials of using an ECG in clinical practice with minimal theory and maximum practicality. An ECG lead is a graphical representation of the heart’s electrical activity calculated by analysing data from several ECG electrodes. Chest leads The ECG abnormalities do not change! During a STEMI, the changes will evolve – in benign early repolarisation, they will remain the same. Typically, the J point is raised with widespread ST elevation in multiple territories making ischaemia less likely. In healthy individuals, the electrical activity of the heart begins at the sinoatrial node then spreads to the atrioventricular (AV) node. It then spreads down the bundle of His and Purkinje fibres to cause ventricular contraction.