1. How to interpret an ECG

2. Steps 1.What are you looking for – ischaemia, arrhythmia, drugs 2.Rate 3.Rhythm 4.Axis 5.Intervals – PR, QT, QRS 6.QRS – BBB, brugada, HOCM 7.ST/T 8.Extras – U wave, osborne, epsilon, delta

3. What are you looking for? Most important question Syncope vs chest pain vs drug overdose Syncope: Brugada, HOCM, QT, Heart block, ARVD Chest pain – Localised ST/T changes, new BBB Drugs – Typical ECG for TCAs, Dig, QRS, QTc

4. Rate Big squares between complexes vs rate 1234567 30015010075605042 Or count the number of complexes in the ECG and multiply by 6

5. Rhythm Regular/irregular? Are there P waves? Is each P wave followed by a QRS complex? If not, is the QRS broad or narrow?

6. Axis Upright in I and AvF means axis between 0 and 90 Sum vectors if you want more – plot lead I on x and AVF on y (heading down)