ECG Clinical Interpretation: A-Z by diagnosis

A

• Accelerated idioventricular rhythm
• Accelerated junctional rhythm
• Anterior STEMI
• Apical hypertrophic cardiomyopathy (AHC)
• Arrhythmogenic right ventricular dysplasia
• Ashman Phenomenon
• Aslanger Pattern (OMI)
• Atrial flutter
• Atrial fibrillation
• Atrial ectopic beat / atrial premature beat
• Atrial tachycardia
• Automatic junctional tachycardia
• AV block: 1st degree
• AV block: 2nd degree, Mobitz I (Wenckebach)
• AV block: 2nd degree, Mobitz II (Hay)
• AV block: 2nd degree, “fixed ratio blocks” (2:1, 3:1)
• AV block: 2nd degree, “high grade AV block”
• AV block: 3rd degree (complete heart block)
• AVNRT (AV-nodal re-entry tachycardia)
• AVRT (atrioventricular re-entry tachycardia)
• Axis Interpretation

B

• Belhassen type VT
• Benign early repolarisation
• Beta-blocker toxicity
• Bidirectional VT
• Bifascicular block
• Biventricular enlargement
• Biatrial enlargement
• Brugada syndrome
• Bundgaard syndrome

C

• Calcium-channel blocker toxicity
• Carbamazepine cardiotoxicity
• Cardiomyopathy, dilated
• Cardiomyopathy, hypertrophic
• Cardiomyopathy, restrictive
• Chronic obstructive pulmonary disease (COPD)

D

• Delta wave
• De Winter T waves and STEMI
• Dextrocardia
• Digoxin effect
• Digoxin toxicity
• Dilated cardiomyopathy

E

• ECG in Toxicology
• Ectopic atrial tachycardia
• Electrical alternans
• Emphysema
• Epsilon wave
• Escape rhythms, junctional
• Escape rhythms, ventricular

F

• Fascicular VT
• Fusion beats

H

• High take-off
• Hypercalcaemia
• Hyperkalaemia
• Hyperthyroidism
• Hypertrophic cardiomyopathy (HCM)
• Hypocalcaemia
• Hypokalaemia
• Hypomagnesaemia
• Hypothermia
• Hypothyroidism

I

• Interventricular Conduction Delay (QRS widening)
• Intracranial haemorrhage
• Intrinsicoid deflection

J

• J-point elevation
• Jervell and Lange-Nielsen Syndrome (JLNS)
• Junctional ectopic beat / junctional premature beat
• Junctional escape rhythm
• Junctional tachycardia

K

• Katz-Wachtel phenomenon
• Killer ECG Rhythms

L

• Lateral STEMI
• Lead reversals: Limb Lead Reversals (overview)
• Lead reversal: Left arm/right arm
• Left atrial enlargement
• Left anterior fascicular block
• Left axis deviation
• Left bundle branch block (LBBB)
• Left bundle branch block — diagnosing myocardial infarction (Sgarbossa criteria)
• Left main coronary artery occlusion (ST elevation in aVR)
• Left posterior fascicular block
• Left ventricular aneurysm
• Left ventricular hypertrophy
• Lenègre-Lev disease
• Lown-Ganong-Levine syndrome
• Low QRS Voltage

M

• Masquerading Bundle Branch Block (MBBB)
• Movement artefact
• Multifocal atrial tachycardia
• Myocardial ischemia
• Myocarditis

N

• Non-paroxysmal junctional tachycardia

O

• OMI: Replacing the STEMI misnomer
• Osborn wave

P

• Pacemaker rhythms: Normal pacemaker function
• Pacemaker malfunctions: Failure of capture, pacemaker-mediated tachycardia, etc.
• Paroxysmal atrial tachycardia (PAT)
• Pediatric ECG
• Pericardial effusion / tamponade
• Pericarditis
• Persistent ST elevation (LV aneurysm morphology)
• Polymorphic ventricular tachycardia
• Poor R wave progression (PRWP)
• Posterior STEMI
• Preexcitation syndrome
• Premature complexes, atrial
• Premature complexes, junctional
• Premature complexes, ventricular
• Pulmonary disease, chronic
• Pulmonary embolism

Q

• QRS widening
• QT syndrome – Long (LQTS)
• QT syndrome – Short (SQTS)
• Quetiapine toxicity

R

• Raised intracranial pressure
• Restrictive cardiomyopathy (myocardial infiltrative disease)
• Right atrial enlargement (RAE)
• Right axis deviation (RAD)
• Right bundle branch block (RBBB)
• Right ventricular hypertrophy (RVH)
• Right ventricular Infarction
• Right ventricular outflow tract (RVOT) tachycardia
• Right ventricular strain
• Romano-Ward syndrome (LQTS)
• R-wave peak time

S

• Sgarbossa criteria (diagnosing AMI in LBBB)
• Shivering artefact
• Short QT syndrome
• Sinus rhythm
• Sinus arrhythmia
• Sinus bradycardia
• Sinus node dysfunction (Sick sinus syndrome)
• Sinus node exit block
• Sinus node reentrant tachycardia
• Sinus pause / arrest
• Sinus tachycardia
• Sodium channel blocker overdose
• South African Flag Sign
• ST elevation in aVR (LMCA/3VD)
• STEMI, anterior
• STEMI, high lateral
• STEMI, inferior
• STEMI, lateral
• STEMI (old)
• STEMI, posterior
• STEMI, right ventricular
• Subarachnoid haemorrhage
• Supraventricular tachycardia (SVT)

T

• Tako Tsubo Cardiomyopathy
• Torsades de Pointes
• Tremor artifact
• Tricyclic overdose (sodium-channel blocker toxicity)
• Triple vessel disease
• Trifascicular block

V

• V1 and V2 Misplacement
• Ventricular aneurysm
• Ventricular escape rhythm
• Ventricular fibrillation
• Ventricular flutter
• Ventricular ectopics / ventricular premature beats
• Ventricular tachycardia: Fascicular VT
• Ventricular tachycardia: Monomorphic VT
• Ventricular tachycardia: Overview of VT
• Ventricular tachycardia: Right Ventricular Outflow Tract (RVOT) tachcyardia
• VT versus SVT with aberrancy

W

• Wellens Syndrome
• Wolff-Parkinson White Syndrome

Y

• Yamaguchi Syndrome

Advanced Reading

Online

• Wiesbauer F, Kühn P. ECG Mastery: Yellow Belt online course. Understand ECG basics. Medmastery
• Wiesbauer F, Kühn P. ECG Mastery: Blue Belt online course: Become an ECG expert. Medmastery
• Kühn P, Houghton A. ECG Mastery: Black Belt Workshop. Advanced ECG interpretation. Medmastery
• Rawshani A. Clinical ECG Interpretation ECG Waves
• Smith SW. Dr Smith’s ECG blog.
• Wiesbauer F. Little Black Book of ECG Secrets. Medmastery PDF

Textbooks

• Zimmerman FH. ECG Core Curriculum. 2023
• Mattu A, Berberian J, Brady WJ. Emergency ECGs: Case-Based Review and Interpretations, 2022
• Straus DG, Schocken DD. Marriott’s Practical Electrocardiography 13e, 2021
• Brady WJ, Lipinski MJ et al. Electrocardiogram in Clinical Medicine. 1e, 2020
• Mattu A, Tabas JA, Brady WJ. Electrocardiography in Emergency, Acute, and Critical Care. 2e, 2019
• Hampton J, Adlam D. The ECG Made Practical 7e, 2019
• Kühn P, Lang C, Wiesbauer F. ECG Mastery: The Simplest Way to Learn the ECG. 2015
• Grauer K. ECG Pocket Brain (Expanded) 6e, 2014
• Surawicz B, Knilans T. Chou’s Electrocardiography in Clinical Practice: Adult and Pediatric 6e, 2008
• Chan TC. ECG in Emergency Medicine and Acute Care 1e, 2004

LITFL Further Reading

• ECG Library Basics – Waves, Intervals, Segments and Clinical Interpretation
• ECG A to Z by diagnosis – ECG interpretation in clinical context
• ECG Exigency and Cardiovascular Curveball – ECG Clinical Cases
• 100 ECG Quiz – Self-assessment tool for examination practice
• ECG Reference SITES and BOOKS – the best of the rest