ECG Interpretation
Results:
Short QT Interval: DDx
Key Points: Short QT Interval: A QT interval is considered short when the corrected QT (QTc) interval is less than 350 ms. A short QT interval on the ECG can…
Post-Thrombolytic Reperfusion ECG Findings
Key Points Reperfusion after fibrinolysis is a bedside diagnosis using a bundle of findings: symptoms, ECG trend, and hemodynamic/electrical stability. Best ECG marker of successful fibrinolysis: at least 50% ST-segment…
ECG Evidence of Reperfusion After Occlusion
Key Points Reperfusion and re-occlusion can occur spontaneously or after therapy. The ECG often reflects these changes earlier than symptoms. Most useful bedside ECG marker of reperfusion is ST-segment resolution…
Pulse-Tapping Artifact
Key Points Mechanical artifact caused by an ECG electrode sitting on top of a strong arterial pulse. Seen frequently in dialysis patients with AV fistulas. Can mimic serious pathology including…
Pediatric ECG Red Flags
Key Points Any wide QRS (>90 ms) in an infant or small child is abnormal and should trigger evaluation for VT, sodium-channel blockade, or conduction disease. QTc >450 ms in…
Pediatric ECG in Cardiac Arrest
Key Points ECG rhythms in pediatric arrest differ from adults. Pulseless arrest in children is most often asphyxial, but ECG clues can reveal reversible metabolic, toxicologic, or structural causes. Wide…
Pediatric ECG: Basics
Key Points Pediatric ECGs are not scaled-down adult ECGs. Right axis deviation, large R waves in V1, and T wave inversions in V1 to V3 are expected in healthy children….
The Life Savers: Critical ECG Patterns
Key Points Definition: Critical ECGs are time-sensitive, life-threatening cardiac or systemic conditions that demand immediate ECG recognition to prevent death or irreversible organ injury. These are the “can’t-miss” rhythm strips…
Post-Cardiac Arrest ECGs
Key Points Early post-ROSC ECGs often mislead. Within the first 8–10 minutes, transient global ischemia and catecholamines can exaggerate ST changes. Plan a repeat at 10–15 minutes before making cath…
Premature Junctional Complexes (PJCs)
Key Points PJCs are premature impulses from ectopic foci in or near the AV junction. ECG hallmark is a narrow premature beat with an absent or retrograde P wave. Retrograde…
J Point: Basics
Key Points The J point is the junction where QRS ends and the ST segment begins. It is a location, not a waveform. ST deviation is judged at the J…
J Wave: Basics
Key Points Definitions: The J point is the QRS–ST junction (a location). A J wave is an added deflection at or just after that point (notch or slur). Why it…
Proper ECG Electrode Placement
Key Points A diagnostic 12‑lead ECG is only as good as your electrode placement. Misplacement can mimic MI, BBB, or poor R‑wave progression and trigger unnecessary workups. A standard 12‑lead…
ECG Findings in Tension Pneumothorax
Key Points Tension pneumothorax is a clinical diagnosis—ECG changes are nonspecific but can provide supportive evidence in the right context. Electrical changes are primarily due to mechanical effects of air…
ECG Findings in Aortic Dissection
Key Points Aortic dissection or aneurysm can produce ischemic‑appearing ECGs due to coronary malperfusion, most often right coronary involvement causing inferior changes. Pseudo‑infarction patterns, ST‑deviation, and conduction blocks can occur…
Epsilon Waves
Key Points Definition: Small, low-amplitude positive deflections at the terminal QRS or very early ST segment, caused by delayed right ventricular activation through diseased myocardium. Association: Highly specific for arrhythmogenic…
Right Ventricular Hypertrophy (RVH)
Key Points Definition: Chronic pressure/volume overload → thickened RV (pulm HTN, congenital lesions, pulmonary disease). ECG signature: Rightward axis, dominant R in V1, deep S in V5–V6, with possible right-sided…
Q Wave: Basics
Key Points Definition and Measurement: A Q wave is the first negative deflection of the QRS. Measure width in ms from the onset below baseline to its return to baseline;…
QRS Complex: Basics
Key Points Definition and measurement: The QRS complex is ventricular depolarization, measured from the earliest ventricular deflection (Q or R) to the latest S return to baseline in any lead….
QT Interval: Basics
Key Points Definition: QT = onset of QRS → end of T; reflects total ventricular depolarization + repolarization. Rate correction (QTc): Use corrected QT interval, because QT shortens with faster…
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