ECGs Made Easy?

Learning all of ECG interpretation is going to take time and it is not quite so easy. To be proficient, it will take effort. Some memorization and pattern recognition will be required. The more you see, the more you will remember. Having a pair of calipers is helpful.

Step 1. Learn the Basics of a 12-lead ECG Tracing

Knowing the basic parts of an ECG tracing will lay a good foundation for everything else that is to come. The different waves, complexes and intervals need to be ingrained in your brain. How many seconds is a full ECG tracing? How much time does each big box and each little box represent?

This is not the time to learn about the different P-wave morphologies that occur with atrial enlargements and ectopic atrial rhythms — but rather, it is the time to learn what the normal P wave looks like and what it represents. It’s a similar concept for the other parts of the ECG.

Step 2. Determine Heart Rate on the ECG

To determine whether bradycardia, a normal heart rate or tachycardia is present requires the knowledge to calculate the heart rate on the ECG. Remember to apply these techniques to both the atrial rate, which is measured by the rate of the P wave, and the ventricular rate, which is measured by the rate of the QRS complex.

Step 3. Determine Axis on the ECG

The axis on the ECG can give a clue to many different pathologic states. Unless you are going into electrophysiology as a career, the only axis that you need to measure is that of the QRS complex.

Know the causes of left axis deviation, right axis deviation and when the axis is indeterminate (northwestern). Also, know the quick shortcuts to determine the axis.

Step 4. Learn Abnormal Heart Rhythms

Step 5. Learn Chamber Hypertrophies and Bundle Blocks

Step 6. Learn Acute MI and Ischemic ECG Findings

Step 7. Learn the Everything Else Including Atypical ECG Findings

Step 8. Quiz, Quiz, Quiz and Review, Review, Review

Step 9. Review ECGs in Real Patient Case Scenarios

Step 10. Teach Others How to Read an ECG