ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD,...

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ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics

Transcript of ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD,...

Page 1: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

ECG Pattern Recognition

Siddharth Prakash, MD, PhDAssociate Professor

Cardiology and Medical Genetics

Page 2: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Recommended ECG Book

+ECGpedia

Page 3: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

ECG Interpretation: Steps

• Identify common ECG pattern• Underlying electrophysiologic disturbance

• Pathophysiology • Differential diagnosis

Page 4: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.
Page 5: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 1

Page 6: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 1

Page 7: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 1

Page 8: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 1

Page 9: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 1

Page 10: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

ECG Interpretation: Steps

• Identify common ECG pattern• Underlying electrophysiologic disturbance

• Pathophysiology • Differential diagnosis

Page 11: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 1: STEMIs

Page 12: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Early Repolarization: Normal Variant

Page 13: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 2

Page 14: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 2

Page 15: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 2

Page 16: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 2

Page 17: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 2

Page 18: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 2: Ischemic ST changes

Page 19: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 3

Page 20: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 3

Page 21: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 3

Page 22: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 3

Page 23: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 3

Page 24: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 3: AV Blocks

Page 25: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip:?

Page 26: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip: 2nd degree Type 1 AV Block

Page 27: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip: ?

Page 28: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip: 2nd degree AV block, type 1 or 2

Page 29: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip: ?

Page 30: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip: 2nd degree AV block, type 2

Page 31: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 4

Page 32: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 4

Page 33: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 4

Page 34: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 4

Page 35: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 4

Page 36: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 4: Ventricular hypertrophyQRS criteria for RVH:Right axis deviation (>90 degrees)An R/S ratio > 1 in lead V1 An R wave > 7 mm tall in Vl, (not the R' of RBBB)An rsR' complex in V 1 (R' > 10 mm)An S wave > 7 mm deep in leads V5 or V6

Page 37: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 5

Page 38: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 5

Page 39: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 5

Page 40: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 5

Page 41: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 5

Page 42: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 5

Page 43: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 5

Page 44: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 5: Bundle Branch Blocks

Page 45: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip:?

Page 46: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip: Premature Atrial Contractions

Page 47: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip:?

Page 48: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip: Premature Atrial Contractions with Aberrant 

Conduction

Page 49: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.
Page 50: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.
Page 51: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Effect of Blocks on Axis

RBBB:Axis unaffected (determined by LBB)

LPFB:Initial depolarization lateralQRS axis down and to the rightNegative in lateral leads

LAFB:Initial depolarization inferiorQRS axis up and to the leftNegative in inferior leads

Page 52: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 6

Page 53: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Calculating Heart Rate

Page 54: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 6

Page 55: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 6

Page 56: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 6

Page 57: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 6

Page 58: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 6

Page 59: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.
Page 60: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 6: Tachycardias

Page 61: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip:?

Page 62: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip: Ventricular fibrillation

Page 63: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip:?

Page 64: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Rhythm Strip:Torsade de Pointes

Page 65: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Long QT

Page 66: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Delta Wave

Page 67: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7

Page 68: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7

Page 69: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7

U wave

Page 70: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7

Page 71: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7Osborn or J waveShort QT

Page 72: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7

Page 73: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7Long QT

Page 74: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7

Page 75: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7: Electrolyte Abnormalities

Page 76: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

Group 7: Electrolyte Abnormalities

Page 77: ECG Pattern Recognition - McGovern Medical School · ECG Pattern Recognition Siddharth Prakash, MD, PhD Associate Professor Cardiology and Medical Genetics. Recommended ECG Book +ECGpedia.

After intervention…