ECG Record

RATE-1
RHYTM-2
AXIS-3
HYPERTROPHY-4
ISCHEMIA,INJURY& INFARCTION-5
MISCELENOUS-6

Long Strip (Lead II)

10

150 / minute)= X 0.04 10 (60

15

100/minute)=X 0.04 15 (60

QRS

QRS

QRS

QRS

0
N

90

F
I

F
NORMAL

A-ATRIAL

VENTRICULAR

QRS

L II

V1 & V6

)P wave in lead II)

NORMAL

P
2.5mm>
)H(

s (W) 0.12>

B-VENTRICULAR

QRS
V1 (RVH)
&
V6(LVH)

NORMAL SEQUENCE OF
CARDIAC DEPOLARIZATION
SMALL r
LARGE S

SMALL q
LARGE R

7mm>

25mm>
V6

V1

V1

R Progression
S Regression

V6

Cardiac Insuilt-5

Injury
S-T Segments of All*
Leads
Isoelectric*
Coincide with=
baseline
No Injury

Ischemia
S-T Segments & T-Waves*
in All leads

II

Isoelectric S-T Segment

with normal T wave
direction
No Ischemia

Normal inverted T
aVR-V1

Infarction
Q wave in All leads*
Normal Q waves

V6

No Infarction

Normal Q wave

Only in

LI-aVL-V6

3mm>

Axis-1
Atrial Hypertrophy-2
Ventricular Hypertrophy-3
Myocardial insult-4
Conductive disturbances-5
Arrythmias-6
Miscellanous-7

R
D
LA

0
D
A
R

F
F

RAD

90

I
F
NORMAL

LAD

)P wave in lead II)

P =3.5 mm(H)

P>2.5mm(H)
s(W) 0.12>

P=0.16 s(W)

RAH

NORMAL

LAH

7>
mm

25>
mm

10

V1

Larger R1 > 7mm

Ventricular
Hypertrophy
N

SMALL (r)
LARGE (S)

V6
SMALL (q)
LARGE (R)

RVH
LVH
Larger R6 > 25mm
Voltage pattern-1
Axis deviation-2
Strain pattern-3

V6

30

Injury

Ischemia

Normal inverted T
aVR-V1

Lateral myocardial infarction is present as evidenced

by abnormally large and wide Q waves in leads I,and V5
& V6 & inversion of TV6 & elevation of ST segment in

.V5 & V6

ECG AS A DIAGNOSTIC TOOL

NORMAL ECG-1
RAD-2
LAD-3
RVH-4
LVH-5

ECG TRACING
OF 9 MONTHS
OLD INFANT

COMMENT

ECG TRACING
OF 9 MONTHS
OLD INFANT

RAD

COMMENT

ECG TRACING
OF 9 MONTHS
OLD INFANT

LAD

COMMENT

ECG TRACING
OF 9 MONTHS
OLD INFANT

RVH

COMMENT

ECG TRACING
OF 9 MONTHS
OLD INFANT

LVH

COMMENT

V1

ECG TRACING
OF 9 MONTHS
OLD INFANT

COMMENT

SYSTEMATIC INTERPERTATION OF ECG

RATE-1
(STRIP,LII)
.100/min)=15X0.04(60

RHYTHM-2
Strip(II)
)Regular, Sinus Rhythm(
P wave is uprightP weave before every QRSnormal QRS morphology-

:AXIS-3
)L I & avF(
)QRS positive in lead I & avF(

F
I
Normal axis

:HYPERTROPHY-4
(V1 &V6)
NO
Ventricular hypertrophy
V1(rS) & V6(qR)
r1> 7mm no RVH
R6 >25mmno LVH

CARDIAC INSULT-5
)All leads(
A-No ischemia (ST-segment is isoelectric
& no pathological inversion of T-wave)
B-No injury (ST-segment is isoelectric)
C-No infarction (no pathological Q-wave)

CONCOLUSION

Normal Sinus Rhythm

NORMAL ECG TRACING