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    10 Steps To Learn ECG Interpretation

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    Mohammad
    The document outlines 10 steps to learn ECG interpretation: 1) Learn the basics of a 12-lead ECG tracing 2) Determine heart rate on the ECG 3) Determine axis on the ECG 4) Learn abnormal heart rhythms 5) Learn chamber hypertrophies and bundle blocks 6) Learn acute MI and ischemic ECG findings 7) Learn atypical ECG findings 8) Quiz yourself and review gaps in knowledge 9) Review ECGs in real patient case scenarios 10) Teach others to solidify your own skills in ECG interpretation.

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    10 Steps To Learn ECG Interpretation

    Uploaded by

    Mohammad
    258 views5 pages
    The document outlines 10 steps to learn ECG interpretation: 1) Learn the basics of a 12-lead ECG tracing 2) Determine heart rate on the ECG 3) Determine axis on the ECG 4) Learn abnormal heart rhythms 5) Learn chamber hypertrophies and bundle blocks 6) Learn acute MI and ischemic ECG findings 7) Learn atypical ECG findings 8) Quiz yourself and review gaps in knowledge 9) Review ECGs in real patient case scenarios 10) Teach others to solidify your own skills in ECG interpretation.

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    10 Steps to Learn ECG Interpretation

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    10 Steps to Learn ECG Interpretation

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    The document outlines 10 steps to learn ECG interpretation: 1) Learn the basics of a 12-lead ECG tracing 2) Determine heart rate on the ECG 3) Determine axis on the ECG 4) Learn abnormal heart rhythms 5) Learn chamber hypertrophies and bundle blocks 6) Learn acute MI and ischemic ECG findings 7) Learn atypical ECG findings 8) Quiz yourself and review gaps in knowledge 9) Review ECGs in real patient case scenarios 10) Teach others to solidify your own skills in ECG interpretation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    258 views5 pages

    10 Steps To Learn ECG Interpretation

    Uploaded by

    Mohammad
    The document outlines 10 steps to learn ECG interpretation: 1) Learn the basics of a 12-lead ECG tracing 2) Determine heart rate on the ECG 3) Determine axis on the ECG 4) Learn abnormal heart rhythms 5) Learn chamber hypertrophies and bundle blocks 6) Learn acute MI and ischemic ECG findings 7) Learn atypical ECG findings 8) Quiz yourself and review gaps in knowledge 9) Review ECGs in real patient case scenarios 10) Teach others to solidify your own skills in ECG interpretation.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    3/12/2019 10 Steps to Learn ECG Interpretation | LearntheHeart.

    com

    Blog
    10 Steps to Learn ECG Interpretation
    Learning the art of ECG interpretation requires intellect, commitment, e ort and — perhaps most
    importantly — an organized approach. I personally have spent thousands of hours (yes, thousands)
    looking at 12-lead ECG tracings, studying ECGs for the cardiology boards, interpreting ECGs for direct
    patient care and developing ECG tutorials and quizzes for LearntheHeart.com.
    Assuming that most of you reading this blog do not have that much time, please allow me to share
    what I have discovered in my years teaching ECGs to make the process more simple — and maybe
    even enjoyable.

    ECGs Made Easy?


    I imagine it is understood that learning all of ECG interpretation is going to take more than 10
    minutes of your time and that it is not quite so easy. To be proficient, it will take a bit of e ort. Some
    memorization and pattern recognition will be required. The more you see, the more you will
    remember. Having a pair of calipers is helpful. But when using LearntheHeart.com to learn ECGs,
    don’t scratch your computer monitor please. Now that this is understood, let’s get down to it.

    Step 1. Learn the Basics of a 12-lead ECG Tracing


    First things first. Knowing the basic parts of an ECG tracing will lay a good foundation for everything
    else that is to come. The di erent waves, complexes and intervals need to be ingrained in your brain.
    How many seconds is a full ECG tracing? How much time does each big box and each little box
    represent?
    This is not the time to learn the crazy things such as the di erent P-wave morphologies that occur
    with atrial enlargements and ectopic atrial rhythms — but rather, just to know what the normal P
    wave looks like and what it represents. It’s a similar concept for the other parts of the ECG.

    Read ECG Basics.

    Step 2. Determine Heart Rate on the ECG


    To determine whether bradycardia, a normal heart rate or tachycardia is present requires the
    knowledge to calculate the heart rate on the ECG. Remember to apply these techniques to both the
    atrial rate, measured by the rate of the P wave, and the ventricular rate, measured by the rate of the
    QRS complex.

    Read Determining Rate.

    Step 3. Determine Axis on the ECG


    The axis on the ECG can give a clue to many di erent pathologic states. Unless you are going into
    electrophysiology as a career, the only axis that you need to measure is that of the QRS complex.

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    3/12/2019 10 Steps to Learn ECG Interpretation | LearntheHeart.com

    Be sure to know the causes of le axis deviation, right axis deviation and when the axis is
    indeterminate (northwestern). Also, know the quick shortcuts to determine the axis.

    Read Determining Axis.

    Step 4. Learn Abnormal Heart Rhythms


    Learning a normal sinus rhythm was taken care of in Step 1. Now, learn the below rhythms like the
    back of your hand. Be sure to review multiple examples of each in the individual ECG Reviews and
    Criteria sections below.

    Atrial Fibrillation ECG Review


    Atrial Flutter ECG Review

    Atrioventricular Nodal Reentrant Tachycardia (AVNRT) ECG Review

    Atrioventricular Reentrant Tachycardia (AVRT) ECG Review


    Ectopic Atrial Rhythms ECG Review

    First-Degree Atrioventricular (AV) Block ECG Review

    Idioventricular Rhythms ECG Review

    Junctional Rhythms ECG Review

    Multifocal Atrial Tachycardia (MAT) ECG Review

    Second-Degree Atrioventricular (AV) Block Type I (Wenkebach) ECG Review

    Second-Degree Atrioventricular (AV) Block Type II ECG Review

    Sinus Arrhythmia ECG Review


    Sinus Bradycardia ECG Review

    Sinus Tachycardia ECG Review

    Third-Degree Atrioventricular (AV) Block ECG Review

    Ventricular Tachycardia (VT) ECG Review

    Wandering Atrial Pacemaker (WAP) ECG Review

    Step 5. Learn Chamber Hypertrophies and Bundle Blocks


    Sometimes this can be the most di icult part. Atrial enlargements are not too bad, but the criteria
    for le ventricular hypertrophy can drive you crazy. No need to memorize then all, just the main two
    or three.

    Le and right bundle branch are not too bad, either. The “bunny ears” are easy to spot in right
    bundle branch blocks — though not always present. Don’t forget to learn what a non-specific
    interventricular conduction delay looks like, as well.
    Bifascicular Block ECG Review

    Le Anterior Fascicular Block (LAFB) ECG Review

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    3/12/2019 10 Steps to Learn ECG Interpretation | LearntheHeart.com

    Le Atrial Enlargement (LAE) ECG Review

    Le Bundle Branch Block (LBBB) ECG Review

    Le Posterior Fascicular Block (LPFB) ECG Review


    Le Ventricular Hypertrophy (LVH) ECG Review

    Poor R Wave Progression ECG Review

    Right Atrial Enlargement (RAE) ECG Review

    Right Bundle Branch Block (RBBB) ECG Review

    Right Ventricular Hypertrophy (RVH) ECG Review

    Trifascicular Block ECG Review

    Step 6. Learn Acute MI and Ischemic ECG Findings


    This is the fun part of ECG interpretation. Some of the acute MI ECG findings, such as anterior ST
    segment elevations and inferior ST segment elevation MIs, are obvious. The tough part is identifying
    the more subtle ECG changes.

    Know when ST segment elevation is due to ischemia and when it is due to other causes including le
    ventricular aneurysm or le ventricular hypertrophy. Likewise, know when ST segment depression
    is due to digoxin ECG changes.

    Anterior Wall ST Segment Elevation Myocardial Infarction (MI) ECG Review

    Inferior Wall ST Segment Elevation Myocardial Infarction (MI) ECG Review

    Posterior Wall Myocardial Infarction (MI) ECG Review

    Step 7. Learn the Everything Else Including Atypical ECG


    Findings
    Again, some repetition and memorization is required. The list of things that go into this category is
    long — so let’s get going.

    Arrhythmogenic Right Ventricular Dysplasia (ARVD) ECG Review

    Atrial Septal Defect (ASD) ECG Review

    Brugada Syndrome ECG Review

    Dextrocardia ECG Review


    Digoxin E ect ECG Review

    Early Repolarization ECG Review

    Hypercalcemia ECG Review

    Hyperkalemia ECG Review

    Hypertrophic Obstructive Cardiomyopathy (HOCM) ECG Review

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    Hypocalcemia ECG Review

    Hypokalemia ECG Review

    Hypothermia ECG Review


    Le Ventricular (LV) Aneurysm ECG Review

    Limb Lead Reversal ECG Review

    Lown-Ganong-Levine Syndrome ECG Review

    Low Voltage ECG Review

    Neurologic Insult ECG Review

    Pericarditis ECG Review

    Prolonged QT Interval ECG Review

    Pulmonary Embolism ECG Review

    Wellens’ Syndrome ECG Review

    Wol -Parkinson-White (WPW) ECG Review

    Step 8. Quiz, Quiz, Quiz and Review, Review, Review


    Taking ECG quizzes, then reviewing once again when you identify a gap in your knowledge, is key.
    You can never look at too many 12-lead ECG tracings. In my opinion, you should not take a quiz that
    only shows a snippet of an ECG, a QRS complex or just a rhythms strip. In real life, you see full 12-
    lead ECG tracings — so that is how you need to test yourself.

    Step 9. Review ECGs in Real Patient Case Scenarios


    Whether you are a medical student in clinical rotations, an EMT or an internist in practice, looking at
    the ECGs that you encounter in practice is important. See how the ECG fits the clinical scenario.
    Sometimes the best way to remember an ECG findings is to associate it with an interesting case that
    you experienced personally.

    Alternatively, you can practice some ECG cases — online or in a textbook — in which a patient
    scenario is presented to you, then the ECG that goes along with it is revealed.

    Step 10. Teach Others How to Read an ECG


    There is no question whatsoever in my mind that I personally have learned the most about ECG
    interpretation by developing content for LearntheHeart.com and teaching ECG courses in person. If
    you can put yourself in a position to teach students or your colleagues about ECGs, you will solidify
    your skills tremendously. Teach your spouse or your dog. Whatever works for you.

    The Practice of Medicine – Never Stop Learning

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    3/12/2019 10 Steps to Learn ECG Interpretation | LearntheHeart.com

    Just keep on reviewing. One day, you will stop and think “Wow, I think I get it.” Sure, you can
    memorize every criteria and detail about the various ECG findings. But with the availability of
    internet access in the hospital and on your smartphone, why not just bookmark a nice reference
    page? Eventually, if you look things up enough times, you will commit them to memory.

    Follow an ECG blog, and read the articles regularly. This will keep things fresh in your mind and
    introduce you to crazy and/or rare ECG tracings.

    – by Steven Lome, DO, RVT

    RELATED CONTENT: Atrial Arrhythmias ECG Quiz | Beginner ECG Quiz | Chamber
    Enlargements and Axis ECG Quiz | Comprehensive ECG Quiz | Expert ECG Quiz | Heart Blocks
    ECG Quiz | Infarcts and Ischemia ECG Quiz | Miscellaneous ECG Quiz | Ventricular Arrhythmias
    ECG Quiz | ECG Cases

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