Szom bath D . Tornci L.

: EKG w ork book

Al
ltracings
Se pte m be r 13, 2006.

Th is study aid h as be e n pre pare d for clas s room proje ction and
not for printing. If you ne e d a pape r copy, you can by th e one
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Click on th e s e lecte d ite m in th e conte nts to ge tto th e ECG you w ant.
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D r. Szom bath D e zs , D r. Tornci Ls zl, 2005

Re production of th is m ate rialin any form is al
low e d onl
y by
w ritte n pe rm is s ion by th e e ditors and Se m m e lw e is Kiad.

Conte nts
E01
E02
E03
E04
E05
E06
E07
E08
E09
E10
E11
E12
E13
E14
E15
E16
E17
E18
E19
E20
E21
E22

Norm alECG
Norm altracing (m e an axis 45) + s inus tach ycardia
Norm altracing, righ tdeviation (m e an axis 80)
Norm altracing, leftdeviation (m e an axis 10) + s inus bradycardia,
flatT w ave s
Effe ctof re s piration on th e m e an axis (0 30). Th e pos itionalQ
w ave dis appe ars during ins piration.
Sinus tach ycardia, fre q ue ncy: 120/m in
Sinus bradycardia, fre q ue ncy: 50/m in
Re s piratory s inus arrh yth m ia (m e an axis 9 0, righ tdeviation)
Sinus arre st, junctionale s cape be at
Sick Sinus Syndrom e : s inus bradycardia, inte rm itte ntatrialflutte r
w ith AVblock
Atrialpre m ature contractions (APCs ) w ith variable PR inte rvaland
abe rrantconduction
M ultifocalatrialtach ycardia
Atrialfibril
lation, abe rrantl
y conducte d ve ntricular com plexe s ,
tach yarrh yth m ia
Atrialfibril
lation, abs ol
ute arrh yth m ia
Atrialflutte r
Junctional(or atrial) pre m ature contractions in a 4:1 (q uadrige m iny)
patte rn
Junctionale s cape rh yth m (m e s onodalbe ats ), fre q ue ncy 40/m in
Acce lerate d junctionalrh yth m , (inve rte d P w ave s pre ce de th e QR Ss )
Acce lerate d junctionalrh yth m , (inve rte d P w ave s com e afte r th e
QR Ss )
Junctionaltach ycardia (re e ntry), fre q ue ncy 150/m in
Ve ntricular bige m iny (2:1)
Full
y com pe ns ate d ve ntricular pre m ature contractions (VPCs , 3:1 =
trige m iny)

E23 Full
y com pe ns ate d ve ntricular pre m ature contractions (VPCs , 4:1 =
q uadrige m iny), s inus tach ycardia
E24 Sh ortruns of VPCs
E25 Nons ustaine d ve ntricul
ar tach ycardia fol
low ing bige m iny
E26 Runs of ve ntricul
ar tach ycardia w ith s igns of re trograde conduction
to th e atria
E27 Ve ntricul
ar tach ycardia
E28 Ve ntricul
ar tach ycardia
E29 Long QT s yndrom e (QT = 0.56 s , Qtc = 0.50 s )
E30 Tors ade de pointe s type pol
ym orph ic ve ntricul
ar tach ycardia
E31 Ve ntricul
ar fl
utte r
E32 Ve ntricul
ar fl
utte r, fibril
lation and cardiac arre st
E33 Ve ntricul
ar paras ystole w ith fus ion be ats
E34 Firstde gre e atriove ntricular (AV) block (PR 0.33 s )
E35 Se cond de gre e AVblock , W e nck e bach type (M obitz I) w ith a 4:3
conduction ratio. Progre s s ive s h orte ning of th e R R inte rvalis s e e n in
th e firstcycle.
E36 Se cond de gre e AVblock , M obitz II
E37 Se cond de gre e AVblock , w ith 2:1 conduction ratio
E38 Th ird de gre e AVblock
E39 Th ird de gre e AVblock , ve ntricular e s cape rh yth m
E40 H igh grade AVblock . Th e firstQR S is a fus ion be at, th e fourth is a
capture .
E41 Se cond de gre e s inuatrial(SA) block (M obitz I)
E42 Se cond de gre e SA bl
ock (M obitz II)
E43 Com pl
e te righ tbundle branch block (R BBB) (QR S 0.12 s )
E44 Com pl
e te leftbundle branch block (LBBB) (QR S 0.12 s )
E45 R ate de pe nde ntLBBB
E46 Le ftante rior fas cicular bl
ock (h e m ibl
ock , m e an axis 50), APC

E47 R igh tve ntricul

ar h ype rtroph y (m e an axis 100), firstde gre e AV
block
E48 Le ftposte rior h e m ibl
ock , incom pl
e te R BBB
E49 Ve ntricular pre excitation, W ol
ff-Park ins on-W h ite (W PW ) s yndrom e
E50 W PW s yndrom e , tach ycardia w ith w ide QR S com plexe s , junctional
e s cape be at, s inus rh yth m
E51 Alte rnating W PW com pl
exe s
E52 Sh ortPR , narrow QR S, APC, l
e ftante rior h e m ibl
ock
E53 H ypok al
e m ia
E54 H ype rk alem ia
E55 Signs of digitalis e ffe ct
E56 Signs of l
e ftve ntricul
ar strain
E57 Le ftve ntricular h ype rtroph y
E58 R igh tve ntricul
ar h ype rtroph y
E59 Le ftatrialabnorm al
ity (P m itral
e)
E60 Le ftatrialabnorm al
ity (P m itral
e ), righ tdeviation
E61 R igh tatrialabnorm al
ity (P pul
m onal
e)
E62 Sube ndocardialis ch e m ia
E63 H ype racute exte ns ive ante rior infarct, R-re duction. M irror im age s in
th e infe rior l
e ads .
E64 Acute exte ns ive ante rior and l
ate ralinfarction. M irror im age s in th e
infe rior l
e ads . P pul
m onale
E65 Acute ante rolate ralinfarction
E66 Ante rior infarction (R re duction in V3), s inus tach ycardia, s coope d
ST
E67 Subacute ante rior infarction
E68 Subacute l
ate ralinfarction

E69
E70
E71
E72
E73
E74
E75
E76
E77
E78
E79
E80
E81
E82
E83
E84
E85
E86
E87
E88
E89
E9 0

H ype racute , h igh late ralinfarction

H ype racute infe rior and poste rior infarction
Acute infe rior infarctre corde d atdiffe re nttim e points
O ld infe rior infarction
Infe rior and poste rior infarction
Subacute poste rior infarction
Acute infe rior, poste rior, and late ralinfarction
Exte ns ive ante rior non-Q infarction (NQM I)
H ype racute infe rior infarction, atrialfibril
lation
Acute exte ns ive ante rior infarction, atrialfibrillation
Subacute ante rior and old infe rior infarction, firstde gre e AVblock
H ype racute infe rior infarction, s e cond de gre e AVblock (M obitz I)
Acute infe rior infarction, s e cond de gre e AVbl
ock (M obitz I)
Acute infe rior infarction, s e cond de gre e AVbl
ock (2:1)
H ype racute infe rior infarction, th ird de gre e AVbl
ock w ith junctional
e s cape rh yth m
Acute ante rior infarction, R BBB, s inus tach ycardia
Acute ante rolate ralinfarction, com plete LBBB
ECG of a patie ntw ith acute pe ricarditis
Acute ove rload of th e righ tve ntricle (cor pul
m onal
e acutum , SIQIII
patte rn), firstde gre e AVblock
Ce re bral T w ave s caus e d by intracranialh e m orrh age . Long QT
s yndrom e (QT = 0.46 s , Qtc = 0.52 s )
Pace m ak e r rh yth m (LBBB patte rn th e e lectrode is in th e righ t
ve ntricle)
ECG of a patie ntw ith a dualch am be r (atrialand ve ntricul
ar)
pace m ak e r

E01
I

aVR

II

aVL

aVF

III

V4
V1
V5
V2

V3
25 m m /s , 10 m m /m V

V6

E02
I

II

III

V1

V2

V3

aVR

V4

aVL

V5

aVF

V6

25 m m /s , 10 m m /m V

E03
I
V1

II

V2

III

V3

aVR

V4

aVL

V5

aVF

V6

25 m m /s , 10 m m /m V

E04
I

V1

II

V2

III

V3

aVR

V4

aVL

V5

aVF

V6

25 m m /s , 10 m m /m V

E05

II

III
25 m m /s , 10 m m /m V

be lgzs /ins piration

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E06

E07
I

aVR

II

aVL

III

aVF

V1

V2

V3
25 m m /s , 10 m m /m V

V4

V5

V6

E08
I

V1

II

V2

III

V3

aVR

V4

aVL

V5

aVF

V6

25 m m /s , 10 m m /m V

E09

aVL

25 m m /s , 10 m m /m V

E10
V1

V2

II

V3

III

Th e labe ls aVR-aVL-aVF and V1-V2-V3 are m ixe d up in th e pape r ve rs ion of th e w ork book .
aVR

V4

aVL

V5

aVF

25 m m /s , 10 m m /m V

V6

E11
I

II

III

aVR

aVL

aVF

25 m m /s , 10 m m /m V

V1

V2

V3

V4

V5

V6

E12
I

II

III

aVR

aVL

aVF

V1
V4

V2

V3
25 m m /s , 10 m m /m V

V5

V6

E13

II

III

25 m m /s , 10 m m /m V

E14
I

aVR

II

aVL

III

aVF

V1

V4

V2
V5

V3

25 m m /s , 10 m m /m V

V6

E15
I

aVR

II

aVL

III

aVF

V1

V4

V2

V3
25 m m /s , 10 m m /m V

V5

V6

E16
I
II
III
aVR
aVL

aVF
V1

V3

V5
V6
25 m m /s , 10 m m /m V

E17
I

aVR

V1

V4

II

aVL

V2

V5

III

aVF

V3

V6

II

25 m m /s , 10 m m /m V

E18
I

II

III

aVR

aVL

aVF

V1

V4

V2

V5

V3
V6
25 m m /s , 10 m m /m V

E19
I

aVR

II

aVL

III

aVF

25 m m /s , 10 m m /m V

E20
I

II

III

aVR

aVL

aVF

25 m m /s , 10 m m /m V

E21

II

III

25 m m /s , 10 m m /m V

E22

25 m m /s , 10 m m /m V

E23

II

III

25 m m /s , 10 m m /m V

E24
I
V1
II
V2
III
V3

aVR

V4

aVL

V5

aVF

V6

25 m m /s , 10 m m /m V

E25
I

II

aVF

V2

V6

25 m m /s , 10 m m /m V

E26

II

III
25 m m /s , 10 m m /m V

E27
V4

aVR

V1

II

aVL

V2

V5

III

aVF

V3

V6

V1

25 m m /s , 10 m m /m V

E28
V4

aVR

V1

II

aVL

V2

V5

V3
III

aVL

25 m m /s , 10 m m /m V

aVF

V6

E29
I

aVR

II

aVL

III

aVF

Th e lead labe ls are m is s ing in th e pape r ve rs ion of th e w ork book .

V1

V4

V2
V5
V3

25 m m /s , 10 m m /m V

V6

E30

II

V1

25 m m /s , 20 m m /m V

E31
I

II

III

II

III

25 m m /s , 10 m m /m V

25 m m /s , 10 m m /m V

E32

E33

25 m m /s , 10 m m /m V

E34

25 m m /s , 10 m m /m V

E35
I

II

III

aVR

aVL

aVF

25 m m /s , 10 m m /m V

E36

II

25 m m /s , 10 m m /m V

E37

II

III
25 m m /s , 10 m m /m V

E38
I

II

III

aVR

aVL

aVF

25 m m /s , 10 m m /m V

E39

V1

V1

25 m m /s , 10 m m /m V

E40

25 m m /s , 10 m m /m V

E41

II

25 m m /s , 10 m m /m V

E42

25 m m /s , 10 m m /m V

E43
I

aVR

II

aVL

III

aVF

V1

V4

V2

V5

V3

V6

25 m m /s , 10 m m /m V

E44
I

aVR

II

aVL

III

aVF

V1

V2

V3
25 m m /s , 10 m m /m V

V4

V5

V6

E45

25 m m /s , 10 m m /m V

E46
I

II

III

aVR

aVL

aVF

25 m m /s , 10 m m /m V

E47

II

III

aVR

aVL

aVF

25 m m /s , 10 m m /m V

E48
I

aVR

II

aVL

III

aVF

V1

V4

V2

V5

V3

V6

25 m m /s , 10 m m /m V

E49
V1
I

II

III

V2

V3

aVR

V4

aVL

V5

aVF

25 m m /s , 10 m m /m V

V6

E50

II

III

25 m m /s , 10 m m /m V

E51
I

II

III

aVF

V1

25 m m /s , 10 m m /m V

V6

E52
I

II

III

aVR

aVL

aVF

25 m m /s , 10 m m /m V

V1

V2

V3

V4

V5

V6

E53
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E54
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E55
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E56
I

II

V1

V2

III

V3

aVR

V4

aVL

V5

aVF

25 m m /s , 10 m m /m V

V6

E57
I

II

III

V1

V2

V3
25 m m /s , 10 m m /m V

aVR

aVL

aVF

V4

V5

V6

E58
I

aVR

II

aVL

III

aVF

V1

V4

V5
V2
V6
V3
25 m m /s , 10 m m /m V

E59
I

aVR

II

aVL

III

aVF

V1

V4

V2

V5

V3
V6

25 m m /s , 10 m m /m V

E60
I

II

aVR

aVL

III

aVF

V1

V4

V2
V5

V3

25 m m /s , 10 m m /m V

V6

E61
I

II

III

aVR

aVL

aVF

V1

25 m m /s , 10 m m /m V

E62
I

aVR

II

aVL

III

V1

V2

V3

25 m m /s , 10 m m /m V

aVF

V4

V5

V6

E63
I

aVR

II

aVL

III

aVF

V1

V4

V2

V5

V3

25 m m /s , 10 m m /m V

V6

E64
I

II

III

aVR

aVL

aVF

V1
V4
V2
V5
V3
V6
25 m m /s , 10 m m /m V

E65
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E66
I

aVR

II

aVL

III

V1

aVF

V4

V2

V5

V3

V6

25 m m /s , 10 m m /m V

E67
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E68
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E69
I

aVR

II

aVL

III

aVF

V1

V4

V2
V5
V3
V6
25 m m /s , 10 m m /m V

E70
I

aVR

II

aVL

III

aVF

V1

V4

V2

V3
25 m m /s , 10 m m /m V

V5

V6

E71
16:46 h

19 :13 h

aVR

II

aVL

III

aVF

aVR

II

aVL

III

aVF

25 m m /s , 10 m m /m V

V1

V4

V2

V5

V3

V6

V1

V4

V2

V5

V3

V6

E72
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E73
I

aVR

V1

V4

II

aVL

V2

V5

III

aVF

V3

V6

II

25 m m /s , 10 m m /m V

E74
I

II

III

V1

V2

V3

V7

V8

V9

aVR

V4

aVL

V5

VD 2

aVF

V6

VD 3

25 m m /s , 10 m m /m V

VD 1

E75
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E76
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E77

II

III

25 m m /s , 10 m m /m V

E78
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E79
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E80

aVR

II

aVL

III

aVF

aVF

25 m m /s , 10 m m /m V

V1

V4

V2

V5

V3

V6

E81
I

II

III

aVR

aVL

aVF

25 m m /s , 10 m m /m V

E82
I

II

III

aVR

25 m m /s , 10 m m /m V

aVL

aVF

E83

II

III
25 m m /s , 10 m m /m V

aVR

aVL

aVF

E84
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E85
I

aVR

II

aVL

III

aVF

V1

V4

V2

V5

V3

V6

25 m m /s , 10 m m /m V

E86
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E87
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E88
I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

25 m m /s , 10 m m /m V

E89
I

aVR

II

aVL

III

aVF

V1

V4

V2

V5

V3

V6

25 m m /s , 10 m m /m V

E9 0
V1

V4

aVL

V2

V5

aVF

V3

V6

aVR

II

III

II

25 m m /s , 10 m m /m V