‫بسم هللا الرحمن الرحيم‬

ECG Record
 1-RATE

2-RHYTM

3-AXIS

4-HYPERTROPHY

5-ISCHEMIA,INJURY& INFARCTION

6-MISCELENOUS
Long Strip (Lead II)
 10

60 ÷ (10 X 0.04)= 150 / minute

15

60 ÷ (15 X 0.04)=100/minute
QRS QRS QRS QRS
 0 I

90

F
I

NORMAL
A-ATRIAL VENTRICULAR

P QRS

L II V1 & V6
 (P wave in lead II)
NORMAL

P
<2.5mm
(H)

<0.12 s (W)
B-VENTRICULAR

QRS

V1 (RVH)
&
V6(LVH)
 NORMAL SEQUENCE OF
CARDIAC DEPOLARIZATION
SMALL r SMALL q
LARGE S LARGE R

<7mm <25mm

V6

I
V1

V1 R Progression V6
S Regression
5-Cardiac Insuilt
Injury
*S-T Segments of All
Leads

*Isoelectric
=Coincide with
baseline 

No Injury
 Ischemia
*S-T Segments & T-Waves
in All leads

II Isoelectric S-T Segment

with normal T wave
direction 

No Ischemia

Normal inverted T
aVR-V1
 Infarction
*Q wave in All leads

V6 Normal Q waves 

No Infarction

Normal Q wave
Only in LI-aVL-V6
<3mm
1-Axis
2-Atrial Hypertrophy
3-Ventricular Hypertrophy
4-Myocardial insult
5-Conductive disturbances
6-Arrythmias
7-Miscellanous
 L
R

0 I
I
I
90

F
F
F I

RAD F
LAD

NORMAL
 (P wave in lead II)
P<2.5mm(H)
P =3.5 mm(H) P=0.16 s(W)
<0.12 s(W)

RAH NORMAL LAH

 <7 <25
mm V mm
10

Ventricular
V1 Hypertrophy V6
N
Larger R1 > 7mm SMALL (r) SMALL (q)
LARGE (S) LARGE (R)

RVH
LVH

Larger R6 > 25mm

1-Voltage pattern
2-Axis deviation 30
V6
3-Strain pattern
Injury Ischemia

Normal inverted T
aVR-V1
 Lateral myocardial infarction is present as evidenced
by abnormally large and wide Q waves in leads I,and V5
& V6 & inversion of TV6 & elevation of ST segment in

.V5 & V6
ECG AS A DIAGNOSTIC TOOL

1-NORMAL ECG •
2-RAD •
3-LAD •
4-RVH •
5-LVH •
ECG TRACING
OF 9 MONTHS
OLD INFANT

COMMENT
ECG TRACING
OF 9 MONTHS
OLD INFANT
RAD
COMMENT
ECG TRACING
OF 9 MONTHS
OLD INFANT
LAD
COMMENT
ECG TRACING
OF 9 MONTHS
RVH
OLD INFANT

COMMENT
ECG TRACING V1
OF 9 MONTHS
OLD INFANT
LVH
COMMENT
ECG TRACING
OF 9 MONTHS
OLD INFANT

COMMENT
SYSTEMATIC INTERPERTATION OF ECG
1-RATE
(STRIP,LII)

60÷(15X0.04)=100/min.
 2-RHYTHM
Strip(II)
(Regular, Sinus Rhythm)
-P wave is upright
-P weave before every QRS
-normal QRS morphology
 3-AXIS: •
I (L I & avF)
(QRS positive in lead I & avF)

Normal axis F
4-HYPERTROPHY:
(V1 &V6)

NO
Ventricular hypertrophy

V1(rS) & V6(qR)

r1< 7mm no RVH

R6 <25mmno LVH
5-CARDIAC INSULT •
(All leads)
A-No ischemia (ST-segment is isoelectric
& no pathological inversion of T-wave)

B-No injury (ST-segment is isoelectric)

C-No infarction (no pathological Q-wave)

 CONCOLUSION

Normal Sinus Rhythm

NORMAL ECG TRACING