? about 12 lead tracings

EMTWintz

EMTWintz

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In my job as an Insurance examiner I do 12lead ECG's. I just got a new machine (which I think needs callibrated) anyway I have a few that I would like someone to look at. I know the major things to look for but unsure what a certain mark on one of them means. I would also like to know if anyone knows what a widening of the T wave means. Can anyone help? Would be happy to PM the one I have. Thanks
 
akflightmedic

akflightmedic

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Post it on here or link it to an image host such as photobucket or something.

Interesting that the company would have a basic doing ECGs and trying to interpret them. I hope you are not the final authority on insurability....just curious.
 
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EMTWintz

EMTWintz

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bled12345

bled12345

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I'm no expert in ECG's by any means, but the the ekg2 was circled for the bunnyears, which means from my VERY noobile understanding of ECG's is that there is something messed up with the perkinje fibers and the ventricles are depolarizing at messed up times, either that or their is a rerouting in the nerve pathways.... Up means an electrical signal + going towards the lead, - means away.


leads 1 2 3,
AVR AVF AVL, and
v1 v2 v3 v4 v5 v6

are all basically looking at the same thing from different angles, 1 2 3 and like the basic 3 leads, avr avf avl look at kind of the same thing but they are altered slightly ( i forget what the A stands for, i'm such a noob)

and v1 v2 v3 v4 v5 v6 are looking at the various angles of the heart mostly from the left side. its kind of a way to triple check to make sure, and if you have a really good understanding of 12 leads / 15 leads you can discern which artery it is in.

the ECG 1 I believe the handwriting is your questions?

the significant thing there is the ST depression after the QRS complex, which is indicative of non acute heart tissue ischemia, which essentially means that the person HAD a heart attack, and thats symbolizing the permanent damage, where as ST elevation is ACUTE ischemia, which means the heart attack is happening right now. I'm not cardiologist but as to the QRS spike question, I do not believe there is any significance regarding the HEIGHT of a qrs complex, but rather how far away the P wave is, how wide the QRS complex is, rabbit ears, ST elevation / depression etc.


do not expect to figure out 12 lead ecg's or just regular ecg's with a couple of go's at it, its definitely not an over night learning experience. And if you ask any truely GOOD medical professional who is excellent at interpreting them, most of them will say that they are still learning ECG's lol.

If you're really interested, I recommend buying a book, preferably written by a cardiologist / emerg doctor.
 
Ridryder911

Ridryder911

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Since it is not contiguous, it is not ST elevation, the T wave in 1 appears to be maybe a little peaked which could be either by electrolyte imbalance or even improperly placed electrodes. Rather both would be insignificant.


R/r 911
 
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EMTWintz

EMTWintz

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Thanks. I am in the process of trying to find a good book on basic 12 lead interp. Any suggestions. Need something that will lay it out in dumb arse terms
 
Ridryder911

Ridryder911

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Dubin's .. That's all you will need for now.

R/r 911
 
Epi-do

Epi-do

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I second Rid's suggestion. Dubin's is what I used while in medic class and he makes it so easy to understand things.
 
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