ECG MNEUMONICS

[drfaten]

Some ECG finding in heart diseases:
Mitral stenosis:
1-atrial fibrillation
2-RVH ,right axis deviation
3-P mitrale, P pulmonale

Mitral reflux:
1-P mitrale
2-atrial fibrillation
3-left ventricular "diastolic" overload
4-RVH, Right axis deviation.

Tricuspid stenosis:
1-VERY TALL right atrial P wave in standard lead II.
2-1st degree AV block
3-normal QRS axis

Hypertensive heart disease:
1-left atrial P wave
2-left ventricular "systolic " overload

Arrhythmias associated with HYPERthyroidism:
1-sinus tachycardia
2-atrial extrasystoles
3-paroxysmal atrial tachycardia
4-paroxysmal atrial flutter
5-paroxysmal atrial fibrillation
6-idionodal tachycardia
7-paroxysmal nodal tachycardia
NB: Ventricular rhythms are NOT usually associated with hyperthyroidism unless there is a cardiac DECOMPENSATION.

Pulmonic styenosis:
1-P congenitale
2-right ventricular systolic overload
3-right axis deviation

Tricuspid atresia:
1-left axis deviation
2-left ventricular dominance
NB: MOST cases of cyanotic congenital heart disease are associated with RIGHT ventricular dominance and RIGHT axis deviation ; tricuspid atresia is a notable exception .

Ebstein's anormally:
1-TALL peaked P waves in standard lead II
2-RBBB with small amplitude QRS complexes
3-WPW syndrome type B, ie the QRS complex is negative in the right precordial leads
4-paroxysmal supra-ventricular tachycardia

[dr_no3man]

exceptionally wonderful job, thanks doctor for sharing these information and I'd love if you can provide some graphical examples on major EKG findings maybe in another topic so we can more and more understand it.
Thanks again.

[drfaten]

Remember: TALL symmetrical T waves in the precordial leads might be due to :
1-acute subendocardial ischemia , injury or infarction.
2-recovering inferior wall myocardial infarction.
3-hyperacute phase of anterior wall myocardial infarction.
4-Prinzmetal 's angina.
5-true posterior wall myocardial infarctions.
6-hyperkalemia.

Remember: Generalized LOW voltage might be due to :
1-incorrect standardization.
2-emphydema.
3-marked obesity or thick chest wall.
4-pericardial effusion.
5-myxedema.
6-hypopituitarism.
7-Cardiac Amyloid.
8-Severe cardiomyopathy
9-Global Myocardial iscehmia.

Remember: Acute rheumatic frequently associated with :
1-sinus tachycardia.
2-non paroxysmal AV nodal tachycardia( idionodal tachycardia).
3-prolonged PR interval.
4-2nd degree AV block .
5-prolonged QT interval.
NB: it is NEVER associated with 3rd degree AV blocK

[drfaten]

Some observations on abnormal rhythms:

Remember: A slow regular ventricular rhythm might be due to :
1-Sinus bradycardia.
2-Complete AV block with idioventricualr rhythm.
3-Normal sinus rhythm with 2:1 AV block.
4-Normal sinus rhythm with 2:1 SA block (very rare).
5-Atrial flutter with high grade 4:1 AV block.
6-Sinus default with idionodal escape rhythm.
7-Sinus default with idioventricualr escape rhythm.

Remember: Causes of IRREGULAR ventricular rhythm:
1-Atrial fibrillation.
2-frequent and irregularly occurring atrial and or ventricular extrasystoles.
3-Atrial flutter with second degree AV blockand varying AV conduction ratios.
4-Paroxysmal atrial tachycardia with variable second degree AV block .
5-Marked respiratory sinus arrhythmia.

"SLOW' atrial fibrillation:
Slow atrial fibrillation usually reflects treatment with digitalis ; or in the absence of digitalis therapy , a structural nodal disease ( sick sinus syndrome ).A more correct description is " atrial fibrillation with slow or diminished ventricular response

[drfaten]

Remember: Common causes of bigeminal rhythm:
1-alternate ventricular extrasystoles( the commonest cause ).
2-alternate atrial or nodal extrasystoles.
3-any form of 3:2 AV block.
4-atrial flutter with alternating 4:1 and 2:1 AV block.

Remember: Absent P wave might be due to :
1-SA block.
2-Atrial fibrillation.
3-Severe hyperkalemia.
4-AV nodal rhythm ( the P wave might be hidden within the QRS complexes).

Remember: A long PAUSE interrupting a regular rhythm might be caused by:
1-a dropped beat as a result of 2nd degree AV block.
2-a dropped beat as a result of SA block.
3-a blocked or non conducted atrial extrasystole.

NB: extrasystoles occur PREMATURELY , escape beats occur LATE.
NB: when the PR interval becomes progressively shorter, AV dissociation is usually present.

Remember: Paroxysmal atrial rhythm (tachycardia, paroxysmal or flutter fibrillation ) in a young person without obvious evidence of cardiac disease rises the possibility of :
1-Thyrotoxicosis.
2-WPW syndrome.
3-Lone atrial fibrillation

[drfaten]

Causes of SA block:
SA block is a rare ECG finding and might be caused ny:
1-marked sinus bradycardia
2-marked sinus arrhythmia
3-highly trained young athletes
4-digitalis toxixity
5-ureamia
6-hypokalemia
7-sick sinus syndrome

1st degree AV block is associated with:
1-coronary artery disease
2-acute rheumatic carditis
3-Beta blockers
4-digitalis
5-cardiomyopathy

[arifhussainarif]

what an effort! stunning.

[hebaanan]

Thank you  Dr Faten  for your hard work and great contribution.