1. Appendix D Basic 12-Lead Interpretation
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2. Myocardial Damage Caused by lack of oxygen to heart muscle
Ischemia: Initial insult
Injury: Damage caused by continued hypoxia
Infarction: Tissue death from prolonged hypoxia
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3. Infarction Location Inferior Lateral Anterior Surface II, III, aVF
I, aVL, V5, V6
V1, V2, V3, V4
Facing Leads
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4. Are directly over these surfaces
Infarction Location
V3 & V4
V2 & V3 V1
These leads…
Anterior wall of the left ventricle
Anterior wall over the septum
Anterior wall of the right ventricle
Are directly over these surfaces
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5. Grades of Myocardial Damage
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6. Extent of Infarction
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7. Ischemic Changes
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8. Age of Infarction (Transmural MI)
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9. Infarction Location
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10. Anterior Wall Infarction (EKG)
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11. Anterior Wall Infarction (Surfaces)
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12. Lateral Wall Infarction (EKG)
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13. Lateral Wall Infarction (Surfaces)
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14. Inferior Wall Infarction (EKG)
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15. Inferior Wall Infarction (Surfaces)
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16. Atrial Enlargement
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17. Ventricular Enlargement
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18. Rule of 35
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19. Right Bundle Branch Block
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20. Left Bundle Branch Block
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21. Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

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23. Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

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26. Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

27. EKG Abnormalities – P Waves
Wide, flat P waves
No P waves
Abnormality
Hyperkalemia
Suggestive of
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

28. EKG Abnormalities – QRS Complexes
Abnormality
Widening of QRS
Merging QRS and T
Hyperkalemia
Suggestive of
Hypokalemia
Prolonged QT interval
Hypercalcemia
Short QT interval
Hypocalcemia
Digitalis Toxicity
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

29. EKG Abnormalities – ST Segments
Abnormality
Disappearing ST segments
Hyperkalemia
Suggestive of
ST depression
Hypokalemia
Sloping ST segments
Depressed, “scooped” ST segments
Digitalis Toxicity
Elevated, concave ST segments
Pericarditis
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

30. EKG Abnormalities – T Waves
Abnormality
Tall, peaked T waves
Hyperkalemia
Suggestive of
Flattening of T wave
Hypokalemia
Diphasic or inverted T waves
Digitalis Toxicity
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31. EKG Abnormalities – U Waves
Abnormality
Development of U waves
Hyperkalemia
Suggestive of
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32. Analysis Format for 12-Lead EKG Interpretation
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33. Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

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40. Miscellaneous Abnormalities, cont.
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41. Miscellaneous Abnormalities, cont.
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42. Miscellaneous Abnormalities, cont.
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

43. 12-Lead EKG (Practice Tracing #1)
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44. 12-Lead EKG (Practice Tracing #2)
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45. 12-Lead EKG (Practice Tracing #3)
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46. 12-Lead EKG (Practice Tracing #4)
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47. 12-Lead EKG (Practice Tracing #5)
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48. 12-Lead EKG (Practice Tracing #6)
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49. 12-Lead EKG (Practice Tracing #7)
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50. 12-Lead EKG (Practice Tracing #8)
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51. 12-Lead EKG (Practice Tracing #9)
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52. 12-Lead EKG (Practice Tracing #10)
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53. 12-Lead EKG (Practice Tracing #11)
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54. 12-Lead EKG (Practice Tracing #12)
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55. 12-Lead EKG (Practice Tracing #13)
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56. 12-Lead EKG (Practice Tracing #14)
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57. 12-Lead EKG (Practice Tracing #15)
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58. 12-Lead EKG (Practice Tracing #16)
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59. 12-Lead EKG (Practice Tracing #17)
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60. 12-Lead EKG (Practice Tracing #18)
Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ