How To Analyse an ECG Systematically

ECG rhythm analysis

What is it about ECGs that make us take one quick glance at it and want to hide it in the patient’s folder where it belongs? ECG interpretation does take practice and can sometimes be tricky, but being able to identify an ECG that is not normal doesn’t have to be tricky at all! All you need is a process that is followed each and every time in order to analyse an ECG systematically! Continue reading

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Cardiac Axis Deviation

right way wrong way sign

At some point or another, we have all heard someone mumble the terms “ECG axis”, “cardiac axis” or “cardiac axis deviation” when looking at a 12 lead ECG. But what does axis mean? I’ll let you in on a little secret, but you have to promise to tell EVERYONE! Here goes: cardiac axis is just a fancy way to discuss the flow of electrical conduction within the heart. And the kicker? It’s actually a relatively easy concept to understand.  Continue reading

How to Diagnose ANY Cardiac Rhythm Systematically

ecg heart flatline

Narrow complex tachycardia…hmm, but isn’t that supraventricular tachycardia?

Broad complex tachycardia…VT…no wait, it’s VF…hang on, asystole (oh, oh!)

It’s atrial fibrillation…wait, what about atrial flutter?

Regular, no wait…is that irregular?

Let’s not forget all those different heart blocks…

What happened to a good ol’ run of straight forward sinus rhythm?

With so many cardiac rhythms to remember, wouldn’t it be nice to be able to get to the correct diagnosis each and every time? The beauty about cardiac rhythms are that they are all fairly predictable. If you ask the right questions in a systematic manner, it will get you to diagnosing the right cardiac rhythm pretty much every time! Don’t believe me? Why not give it a shot by using this flowchart I have designed to do just that:

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Removing the Road Blocks: Understanding Heart Blocks

cardiac conduction pathway

Ever wondered about the differences between a first, second and third degree atrioventricular (AV) heart block? And not to mention that second degree AV blocks can be further differentiated into type 1 or type 2? You know, because it wasn’t confusing enough as it was! This article is going to explain it all to you! But before we start making heart blocks something that is easy to understand, we should start with a bit of normal electrophysiology through the heart. After all, we can’t understand what is abnormal until we truly understand what is normal! Continue reading

ST What?! Recognising Myocardial Ischaemic ECG Changes!

Acute Coronary Syndrome (ACS) does not refer to an adorable coronary artery too cute for it’s own good; it refers to a group of conditions that result in decreased coronary blood flow to the myocardial tissue. With a decreased coronary blood flow, there is a decreased supply of oxygen to the myocardial tissue. And nothing is as bad to the myocardial tissue than a lack of oxygen! If you are the superstitious type, you will believe that all bad things come in threes. No truer words have ever been spoken, with the 3 issues that result from a lack of oxygen to the myocardial tissue all starting with a capital “I”…
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Demystifying the 12 Lead ECG!

ecg dot application hair removal image

Whether you work within a coronary care unit or a general surgical unit, we have all performed a 12 lead electrocardiogram (ECG) on one of our patients at some point or another. We’ve prepped the chest of a patient that could rival some of the sheep shearing competitions that occur in New Zealand. We’ve tried untangling the mess of leads while secretly imagining the face of the colleague that left the ECG machine in such disarray on the dart board of our local bar. We’ve all had to deal with that ONE patient who cannot comprehend what it means to “lie still and quietly”. And after all of that effort to get that perfect print out of an ECG, wouldn’t it be nice to understand what those 12 leads are actually telling you?  Continue reading