By : Dr. Subrahmanyam Karuturi
> ST elevation ELEVATION
Electrolytes, LBBB, Early Repolarization, Ventricular hypertrophy, Aneurysm, Treatment (eg
pericardiocentesis), Injury (AMI, contusion), Osborne waves (hypothermia), Non-occlusive
> Exercise ramp ECG: contraindications RAMP:
MI in the last 7 days
> ECG: T wave inversion causes INVERT:
Normality [esp. young, black]
Ectopic foci [eg calcified plaques]
> EKG: 12 lead EKG quick interpretation of V1-V6 SSAALL:
· Elevations matched with their classic location of MI:
> Pericarditis: EKG "PericarditiS":
PR depression in precordial leads.
> Depressed ST-segment: causes DEPRESSED ST:
Drooping valve (MVP)
Enlargement of LV with strain
Potassium loss (hypokalemia)
Reciprocal ST- depression (in I/W AMI)
Embolism in lungs (pulmonary embolism)
Encephalon haemorrhage (intracranial haemorrhage)
Toxicity of digitalis, quinidine
> ECG: left vs. right bundle block "WiLLiaM MaRRoW":
W pattern in V1-V2 and M pattern in V3-V6 is Left bundle block.
M pattern in V1-V2 and W in V3-V6 is Right bundle block.
· Note: consider bundle branch blocks when QRS complex is wide.
> ST elevation causes in ECG ELEVATION:
Treatment (eg pericardiocentesis)
Injury (AMI, contusion)
Osborne waves (hypothermia)
> Einthoven's Triangle: organization Corners are at RA (right arm), LA (left arm), LL (left leg).
Number of L's at a corner tell how many + signs are at that corner [eg LL is ++].
Sum of number of L's of any 2 corners tells the name of the lead [eg LL-LA is lead III].
For reference axes, the negative angle hemisphere is on the half of the triangle drawing that has all the negative signs; positive angle hemisphere contains only positive signs.
> Dominant R wave in V1 WORD
WPW, Old MI, RBBB, Dextrocardia
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