Welcome to this interactive ECG course.

Although it is one of the oldest paraclinic exams, dating back to the late 19th century, the ECG is still of crucial clinical use. This examination often still poses problems of interpretation to the medical practitioner.

This course aims to help the student, the practicing physician and even the trained cardiologist to improve his knowledge in electrocardiography. It consists of 250 traces of varying complexity with a description of each one by experts. This allows the reader to compare his analysis with that of the experts. In addition, the areas of interest of the ECG can be activated to be clearly highlighted.

We hope that these plots will be useful to readers and will improve their knowledge.

The ECGs are available sorted by keywords and categories.

ECG 015

Description

Basic rhythm

Wide complex tachycardia, slightly irregular at approximately 150 bpm.

P waves

Sometimes visible between 2 QRS complexes at 70 bpm.

PR interval

Not definable.

QRS

Variable duration, but constantly increased; in V1 and V2 pattern typical of right bundle branch block alternating regularly with that of an atypical right bundle branch block; same alternation of the electrical axis which oscillates between between -90° and -105°.

ST segment, T waves

Diffuse non-specific changes in repolarisation.

QT interval

Not measurable.

Zones

QRS alternance with 2 types of QRS. Atypical Rigth Bundle Branch BLock (RBBB).

Diagnostic

Bidirectional ventricular tachycardia. Digitalis intoxication.

Comments

The extreme axis deviation is an indication of ventricular tachycardia, confirmed by A-V dissociation which is poorly visible but suggested in certain leads. This tachycardia is known as bidirectional tachycardia because of the alternation of two QRS complexes with different morphologies which originate in the left (anterior and posterior) hemibranches. This rhythm disturbance generally occurs in the event of digitalis intoxication. In the present case, the level of digoxin in the blood was 5.0 nmol/l (normal level: < 1.5 nmol/l).

Keywords

Reading level

3 / 3

ECG Directory