Szom bath D. Tornóci L.: EKG w ork book A ltracings
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1 Szom bath D. Tornóci L.: EKG w ork book A ltracings Septem ber 13, Th is study aid h as be e n pre pare d for classroom proje ction and not for printing. f you ne e d a pape r copy, you can by th e one publish e d by Se m m e lw e is Kiadó. Th e quality of th is is far supe rior th an w h at you can ge t by printing it yourse lf. Click on th e selected item in th e contents to get to th e ECG you w ant. You can get back to th e contents page by click ing on th e page num ber. Dr. Szom bath Dezső, Dr. Tornóci László, 2005 Reproduction of th is m aterialin any form is a low ed only by w ritten perm ission by th e editors and Sem m elw eis Kiadó.
2 Conte nts E01 Norm alecg E02 Norm altracing (m e an axis 45 ) + s inus tach ycardia E03 Norm altracing, righ t deviation (m e an axis 80 ) E04 Norm altracing, left deviation (m ean axis 10 ) + sinus bradycardia, flat T w aves E05 Effect of respiration on th e m ean axis (0 30 ). Th e positionalq w ave dis appe ars during ins piration. E06 Sinus tach ycardia, fre q ue ncy: 120/m in E07 Sinus bradycardia, fre q ue ncy: 50/m in E08 Respiratory sinus arrh yth m ia (m ean axis 9 0, righ t deviation) E09 Sinus arrest, junctionalescape beat E10 Sick Sinus Syndrom e: sinus bradycardia, interm ittent atrialflutter w ith AV block E11 Atrialprem ature contractions (APCs) w ith variable PR intervaland abe rrant conduction E12 M ultifocalatrialtach ycardia E13 Atrialfibri lation, aberrantly conducted ventricular com plexes, tach yarrh yth m ia E14 Atrialfibri lation, abs olute arrh yth m ia E15 Atrialflutte r E16 Junctional(or atrial) prem ature contractions in a 4:1 (q uadrigem iny) patte rn E17 Junctionalescape rh yth m (m esonodalbeats), freq uency 40/m in E18 Accelerated junctionalrh yth m, (inverted P w aves precede th e QRSs) E19 Accelerated junctionalrh yth m, (inverted P w aves com e after th e QRSs) E20 Junctionaltach ycardia (reentry), freq uency 150/m in E21 Ve ntricular bige m iny (2:1) E22 Fu ly com pensated ventricular prem ature contractions (VPCs, 3:1 = trigem iny) E23 Fu ly com pensated ventricular prem ature contractions (VPCs, 4:1 = q uadrigem iny), sinus tach ycardia E24 Sh ort runs of VPCs E25 Nonsustained ventricular tach ycardia fo low ing bigem iny E26 Runs of ventricular tach ycardia w ith signs of retrograde conduction to th e atria E27 Ve ntricular tach ycardia E28 Ve ntricular tach ycardia E29 Long QT syndrom e (QT = 0.56 s, Qtc = 0.50 s) E30 Torsade de pointes type polym orph ic ventricular tach ycardia E31 Ve ntricular flutte r E32 Ve ntricular flutte r, fibri lation and cardiac arre st E33 Ventricular parasystole w ith fusion beats E34 First de gre e atriove ntricular (AV) block (PR 0.33 s) E35 Second degree AV block, W enck ebach type (M obitz ) w ith a 4:3 conduction ratio. Progressive sh ortening of th e RR intervalis seen in th e first cycle. E36 Second degree AV block, M obitz E37 Second degree AV block, w ith 2:1 conduction ratio E38 Th ird degree AV block E39 Th ird degree AV block, ventricular escape rh yth m E40 H igh grade AV block. Th e first QRS is a fusion beat, th e fourth is a capture. E41 Second degree sinuatrial(sa) block (M obitz ) E42 Second degree SA block (M obitz ) E43 Com plete righ t bundle branch block (RBBB)(QRS 0.12 s) E44 Com plete left bundle branch block (LBBB) (QRS 0.12 s) E45 Rate dependent LBBB E46 Left anterior fascicular block (h em iblock, m ean axis 50 ), APC
3 E47 Righ t ventricular h ypertroph y (m ean axis 100 ), first degree AV block E48 Left posterior h em iblock, incom plete RBBB E49 Ventricular preexcitation, W olff-park inson-w h ite (W PW ) syndrom e E50 W PW syndrom e, tach ycardia w ith w ide QRS com plexes, junctional escape beat, sinus rh yth m E51 Alte rnating W PW com plexe s E52 Sh ort PR, narrow QRS, APC, left anterior h em iblock E53 H ypok alem ia E54 H yperk alem ia E55 Signs of digitalis e ffe ct E56 Signs of le ft ve ntricular strain E57 Left ventricular h ypertroph y E58 Righ t ventricular h ypertroph y E59 Le ft atrialabnorm ality (P m itrale) E60 Le ft atrialabnorm ality (P m itrale), righ t deviation E61 R igh t atrialabnorm ality (P pulm onale) E62 Subendocardialisch em ia E63 H yperacute extensive anterior infarct, R-reduction. M irror im ages in th e inferior leads. E64 Acute extensive anterior and lateralinfarction. M irror im ages in th e inferior leads. P pulm onale E65 Acute ante rolate ralinfarction E66 Anterior infarction (R reduction in V3), sinus tach ycardia, scooped ST E67 Subacute ante rior infarction E68 Subacute late ralinfarction E69 H yperacute, h igh lateralinfarction E70 H ype racute infe rior and poste rior infarction E71 Acute infe rior infarct re corde d at diffe re nt tim e points E72 O ld infe rior infarction E73 nfe rior and poste rior infarction E74 Subacute poste rior infarction E75 Acute infe rior, poste rior, and late ralinfarction E76 Exte ns ive ante rior non-q infarction (NQM ) E77 H ype racute infe rior infarction, atrialfibri lation E78 Acute exte ns ive ante rior infarction, atrialfibri lation E79 Subacute ante rior and old infe rior infarction, first de gre e AV block E80 H yperacute inferior infarction, second degree AV block (M obitz ) E81 Acute inferior infarction, second degree AV block (M obitz ) E82 Acute inferior infarction, second degree AV block (2:1) E83 H yperacute inferior infarction, th ird degree AV block w ith junctional escape rh yth m E84 Acute ante rior infarction, R BBB, s inus tach ycardia E85 Acute ante rolate ralinfarction, com ple te LBBB E86 ECG of a patie nt w ith acute pe ricarditis E87 Acute overload of th e righ t ventricle (cor pulm onale acutum, SQ patte rn), first de gre e AV block E88 Cerebral T w aves caused by intracranialh em orrh age. Long QT syndrom e (QT = 0.46 s, Qtc = 0.52 s) E89 Pacem ak er rh yth m (LBBB pattern th e electrode is in th e righ t ventricle) E9 0 ECG of a patient w ith a dualch am ber (atrialand ventricular) pacem ak er
4 E01 V4 V2 V5 V3 V6
5 E02 V2 V3 V4 V5 V6
6 E03 V2 V3 V4 V5 V6
7 E04 V2 V3 V4 V5 V6
8 E05 be légzés/ins piration
9 E06 V2 V3 V4 V5 V6
10 E07 V4 V2 V5 V3 V6
11 E08 V2 V3 V4 V5 V6
12 E09
13 E10 V2 V3 Th e labels -- and -V2-V3 are m ixed up in th e paper version of th e w ork book. V4 V5 V6
14 E11 V2 V3 V4 V5 V6
15 E12 V4 V2 V5 V3 V6
16 E13
17 E14 V4 V2 V5 V3 V6
18 E15 V4 V2 V5 V3 V6
19 E16 V3 V5 V6
20 E17 V4 V2 V5 V3 V6
21 E18 V4 V2 V5 V3 V6
22 E19
23 E20
24 E21
25 E22
26 E23
27 E24 V2 V3 V4 V5 V6
28 E25 V2 V6
29 E26
30 E27 V4 V2 V5 V3 V6
31 E28 V4 V2 V5 V3 V6
32 E29 Th e lead labels are m issing in th e paper version of th e w ork book. V4 V2 V5 V3 V6
33 E30 25 m m /s, 20 m m /m V
34 E31
35 E32
36 E33
37 E34
38 E35
39 E36
40 E37
41 E38
42 E39
43 E40
44 E41
45 E42
46 E43 V4 V2 V5 V3 V6
47 E44 V4 V2 V5 V3 V6
48 E45
49 E46
50 E47
51 E48 V4 V2 V5 V3 V6
52 E49 V2 V3 V4 V5 V6
53 E50
54 E51 V6
55 E52 V4 V2 V5 V3 V6
56 E53 V2 V3 V4 V5 V6
57 E54 V2 V3 V4 V5 V6
58 E55 V2 V3 V4 V5 V6
59 E56 V2 V3 V4 V5 V6
60 E57 V4 V2 V5 V3 V6
61 E58 V4 V2 V5 V3 V6
62 E59 V4 V2 V5 V3 V6
63 E60 V4 V2 V5 V3 V6
64 E61
65 E62 V4 V2 V5 V3 V6
66 E63 V4 V2 V5 V3 V6
67 E64 V4 V2 V5 V3 V6
68 E65 V2 V3 V4 V5 V6
69 E66 V4 V2 V5 V3 V6
70 E67 V2 V3 V4 V5 V6
71 E68 V2 V3 V4 V5 V6
72 E69 V4 V2 V5 V3 V6
73 E70 V4 V2 V5 V3 V6
74 16:46 h V4 E71 V2 V5 V3 V6 19 :13 h V4 V2 V5 V3 V6
75 E72 V2 V3 V4 V5 V6
76 E73 V4 V2 V5 V3 V6
77 E74 V7 V2 V8 V3 V9 V4 VD1 V5 VD2 V6 VD3
78 E75 V2 V3 V4 V5 V6
79 E76 V2 V3 V4 V5 V6
80 E77
81 E78 V2 V3 V4 V5 V6
82 E79 V2 V3 V4 V5 V6
83 E80 V4 V2 V5 V3 V6
84 E81
85 E82
86 E83
87 E84 V2 V3 V4 V5 V6
88 E85 V4 V2 V5 V3 V6
89 E86 V2 V3 V4 V5 V6
90 E87 V2 V3 V4 V5 V6
91 E88 V2 V3 V4 V5 V6
92 E89 V4 V2 V5 V3 V6
93 E9 0 V4 V2 V5 V3 V6
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