Craig Ernst, MHS, PA-C

 Rate  Rhythm  Axis  Hypertrophy  Infarct  ST-T Changes (injury/ischemia)  Intervals ◦ PR ◦ QRS ◦ QT

 Quick Estimate ◦ “300, 150, 100, 75, 60, 50”  Alternative Methods ◦ 6 second strip and multiply by 10 Or ◦ 1500/# mm between R-R

 P before each QRS?  QRS follows each P?  Regular or Irregular?

 Leads I and AVF ◦ Upright in both = normal axis ◦ Up in I and down in AVF = LAD ◦ Down in I and up in AVF = RAD ◦ Down in both = Extreme RAD

 S in V1 + R in V5 = greater than or equal to 35 mm  R in AVL greater than 11 mm

 Q wave of greater than.04 sec (one small block)  Q wave 1/3 the amplitude or more of the QRS complex

 Injury ◦ ST elevation  Ischemia ◦ ST depression or T wave inversions  Location ◦ Same as for MI

 PR duration: less than 0.12 or greater than 0.20  QRS duration: greater than 0.12  QT duration: greater than 0.44 ◦ Should not be greater than half the R-R interval

 Blocks ◦ 1 st degree ◦ 2 nd degree  Mobitz I  Mobitz II ◦ 3 rd degree

 Ectopy ◦ PVC ◦ PAC

 Tachycardias ◦ Sinus ◦ MAT ◦ PSVT ◦ A-fib ◦ A-flutter ◦ VT

 Potassium  Calcium  Drugs ◦ B-blockers ◦ Calcium channel blockers ◦ Digitalis

Case