20 practice 1
TRANSCRIPT
12-Lead 12-Lead ElectrocardiographyElectrocardiography
a comprehensive course
Adam Thompson, EMT-P, A.S.Adam Thompson, EMT-P, A.S.
Practice-
1
Practice
• Lets take a look at a 12-Lead recording and use the 6-step method to interpret it.
62 y/o MaleComplaining of Chest Pain
62 y/o MaleRate & Rhythm
62 y/o MaleAxis
Rate: 88Normal Sinus
62 y/o Male
62 y/o MaleAxis
Rate: 88Normal Sinus
62 y/o Male
Hexaxial Reference System
• When the mean axis is perpendicular to the positive electrode, the QRS is equiphasic.
+
+
+ A B A
B
62 y/o Male
62 y/o MaleAxis
Rate: 88Normal Sinus
62 y/o Male
62 y/o Male
ERAD LAD
RAD Normal
180 0
-90
90
62 y/o MaleAxis
Rate: 88Normal SinusFrontal Axis: 30
Precordial Axis
V1
V2
V3
V4
V5V6
Normal transition
62 y/o MaleAxis
Rate: 88Normal SinusFrontal Axis: 30
62 y/o MaleIntervals & Morphology
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: Normal
62 y/o MaleIntervals & Morphology
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: Normal
62 y/o MaleIntervals & Morphology
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: Normal
HyperacuteT-Waves
62 y/o MaleSTE-Mimics
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
62 y/o MaleSTE-Mimics
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
62 y/o MaleSTE-Mimics
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
62 y/o MaleSTE-Mimics
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
Lead I
lateral
aVR V1
septal
V4
anterior
Lead II
inferior
aVL
high lateral
V2
septal
V5
low lateral
Lead III
inferior
aVF
inferior
V3
anterior
V6
low lateral
62 y/o MaleIschemia, Injury, Infarct
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
62 y/o MaleIschemia, Injury, Infarct
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
Site Facing Reciprocal
Septal V1, V2 None
Anterior V3, V4 None
Lateral I, aVL, V5, V6 II, III, aVF
Inferior II, III, aVF I, aVL
Posterior V7, V8, V9 V1, V2
62 y/o Male12-Lead #2
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-waves
62 y/o Male
Rate: 88Normal SinusFrontal Axis: 30 Precordial Axis: NormalHyperacute T-wavesAntero-Septal MI
Keep Practicing!!