ECG Directory

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 213

ECG 213

Description

Baseline rhythm

Irregularly irregular.P-waves: visible at a rate of 120 bpm.PR interval: prolonged at 280 ms.QRS: broadened (120 ms), poor R-wave progression.ST segment: elevated from V3 to V6.T-waves: biphasic or flattened.QT interval: normal.

Zones

P waves nicely visible.
Q waves and ST segment elevation.
Old antero-lateral myocardial infarction with Q waves in I and aVL.

Diagnostic

Atypical atrial flutter (type II) with variable conduction, intraventriclar conduction disturbance and ST elevation following anterior wall dyskinesia.

Comments

We see very clearly irregularly-conducted P-waves in V1. This corresponds to an atypical flutter given the morphology of the P’-waves with variable conduction. The QRS is broad but does not really have the morphology of LBBB in the peripheral leads. In the precordial leads, the non-progression of the R-wave is the result of an old anterior infarct with permanent ST elevation which corresponds to a very large aneurysm. This also explains the morphology of the QRS in I, II, aVL and aVF with conduction delay, without it being a true LBBB. In fact, the anterior wall does not exist any more, and therefore neither does the left bundle branch. The aneurysm was huge (> 15 cm in diameter).

Category

Ischemia and myocardial infarction

Keywords

Reading level

2 / 3