Health Education Assets Library (HEAL)
 
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TitleDescriptionSubjectCollection
51 Wandering atrial pacemakerWandering atrial pacemaker is a benign rhythm change where the pacemaker site shifts from the sinus node into the atrial tissues. P-wave morphology varies with the pacemaker site.Knowledge Weavers ECG
52 QRS axis = +60 degreesLead aVL is isoelectric; leads II and III are mostly positive. The QRS axis, therefore, is +60 degrees.Knowledge Weavers ECG
53 Electronic ventricular pacemaker rhythm - marquetteElectronic ventricular pacemaker rhythm - marquetteKnowledge Weavers ECG
54 High lateral wall MI (seen in aVL)High lateral wall MI (seen in aVL)Knowledge Weavers ECG
55 Atrial tachycardia - marquetteAtrial tachycardia - marquetteKnowledge Weavers ECG
56 LVH with StrainLVH with StrainKnowledge Weavers ECG
57 PAC's with RBBB aberrant conductionPAC's are identified by the arrows. Note that the PP interval surrounding the PAC is less than 2x the basic sinus cycle indicating that the sinus node has been reset by the ectopic P wave. The pause after the PAC, therefore, is incomplete.Knowledge Weavers ECG
58 1st degree AV blockThe normal PR interval is 0.12 - 0.20 sec, or 120 -to- 200 ms. 1st degree AV block is defined by PR intervals greater than 200 ms. This may be caused by drugs, such as digoxin; excessive vagal tone; ischemia; or intrinsic disease in the AV junction or bundle branch system.Knowledge Weavers ECG
59 Sore thumbsTwo funny looking premature beats are seen in this rhythm strip. Beat A is preceded by a PAC which distorts the T wave, making this an aberrantly conducted PAC. Beat B is a PVC. The notch on the down slope of the QRS complex clearly identifies this as a PVC and not aberrancy.Knowledge Weavers ECG
60 AV dissociation by defaultIf the sinus node slows too much a junctional escape pacemaker may take over as indicated by arrows. AV dissociation is incomplete, since the sinus node speeds up and recaptures the entricles.Knowledge Weavers ECG
61 Atrial tachycardia with 2:1 AV block: a manifestation of digitalis intoxicationAtrial tachycardia with 2:1 AV block: a manifestation of digitalis intoxicationKnowledge Weavers ECG
62 Accelerated junctional rhythm - marquetteAccelerated junctional rhythm - marquetteKnowledge Weavers ECG
63 First degree AV block - marquetteFirst degree AV block - marquetteKnowledge Weavers ECG
64 AV sequential pacemaker - marquette(Summary)Knowledge Weavers ECG
65 Postero-lateral MI: Fully EvolvedThe true posterior MI is recognized by pathologic R waves in leads V1-2. These are the posterior equivalent of pathologic Q waves (seen from the perspective of the anterior leads). Tall T waves in these same leads are the posterior equivalent of inverted T waves in this fully evolved MI. The loss o...Knowledge Weavers ECG
66 Atrial tachycardia with 3:2 and 2:1 AV blockThe ectopic atrial rate is 150 bpm. Some of the ectopic P waves are easily seen and indicated by the arrows. Other P waves are burried in the T waves and not so easily identified. Atrial tachycardia with AV block is often a sign of digitalis intoxication. 3:2 and 2:1 AV block is seen in this examp...Knowledge Weavers ECG
67 RBBB with primary ST-T wave abnormalitiesRBBB is recognized by 1) rR' in V1; 2) QRS duration>0.12s; 3) terminal QRS forces oriented rightwards and anterior. In RBBB the ST-T waves should be oriented opposite to the terminal QRS forces. In this example there areprimary ST-T wave abnormalitiesin leads I, II, aVL, V5, V6. In these leads th...Knowledge Weavers ECG
68 What are those funny looking beats????The differential diagnosis of funny-looking-beats, or FLB's, primarily considers beats of supraventricular origin with aberrant conduction and ventricular ectopic beats. In this example the two FLB's have an easily seen ectopic P wave before them; therefore these are PAC's with RBBB aberration.Knowledge Weavers ECG
69 Conceptual framework: aArrhythmias and conduction abnormalitiesConceptual framework: aArrhythmias and conduction abnormalitiesKnowledge Weavers ECG
70 Atrial flutter with variable AV block - marquetteAtrial flutter with variable AV block - marquetteKnowledge Weavers ECG
71 Compensatory vs. non-compensatory pauses - marquetteCompensatory vs. non-compensatory pauses - marquetteKnowledge Weavers ECG
72 LVH - best seen in the frontal plane leads!LVH - best seen in the frontal plane leads!Knowledge Weavers ECG
73 Isochronic ventricular rhythmAn isochronic ventricular rhythm is also called an accelerated ventricular rhythm because it represents an active ventricular focus. This arrhythmia is a common reperfusion arrhythmia in acute MI patients. It often begins and ends with fusion beats and there is AV dissociation. Treatment is usuall...Knowledge Weavers ECG
74 LVH: limb lead criteriaIn this example of LVH, the precordial leads don't meet the usual voltage criteria or exhibit significant ST segment abnormalities. The frontal plane leads, however, show voltage criteria for LVH and significant ST segment depression in leads with tall R waves. The voltage criteria include 1) R in...Knowledge Weavers ECG
75 ST segment depressionST segment depression is a nonspecific abnormality that must be evaluated in the clinical context in which it occurs. In a patient with angina pectoris ST depression usually means subendocardial ischemia and, unlike ST elevation, is not localizing to a particular coronary artery lesion.Knowledge Weavers ECG
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