ECG

Question 1

What are the signs of an AMI (new or old) on ECG?

Answer 1

1. ST elevation > 1mm in 2 contiguous limb leadds 2. ST elevation > 2 mm in 2 contiguous chest leads 3. new left bundle branch block 4. T wave inversion 5. Q wave development 6. reciprocal ST depression in leads opposite infarcted region

Question 2

Which leads on an ECG describe the inferior heart? Which arteries supply this area?

Answer 2

II, III, AVF. Right coronary artery.

Question 3

Which leads on an ECG describe the anterior heart? Which arteries supply this area?

Answer 3

I, V2-V5. Left anterior descending artery

Question 4

Which leads on an ECG describe the septal heart? Which arteries supply this area?

Answer 4

V1, V2. Left anterior descending artery, right coronary artery

Question 5

Which leads on an ECG describe the lateral heart? Which arteries supply this area?

Answer 5

I, aVL, V5-V6. Left circumflex artery

Question 6

Mnemonic for remembering how to evaluate ECG systematically

Answer 6

A RARE PQRST

Age, e.g. a 60-yo patient is likely have a different pathology from a 30-yo patient
Rate, e.g. fast or slow?
Axis, e.g. left or right?
Rhythm, e.g. regular or irregular?
Evaluate each EKG element as follows:
P wave, e.g. peaked or absent? PR interval - short or prolonged?
Q wave, e.g. deep Q wave? QT inerval - - short or prolonged?
R wave, e.g. tall? look at QRS complex width for RBBB or LBBB
ST segment, e.g. elevation or depression?
T wave, e.g. peaked or inverted? U wave?