Cardiovascular USMLE

ECG Assessment:
Heart Rate: number of large boxes /2
Assess ECG for Rate, Rhythm, Axis, Intervals, Wave forms, and
chamber enlargement
Rate
Normal Rate: 60-100 bpm
HR<60 Brady
HR>100 Tachy
Rhythm
Sinus: see a regular p wae
Junctional/ Ventricular: missing P wave
Ectopic beats
Axis:
Normal: Upright QRS in leads I and aVF
Left Axis Deviation: Upright in Lead 1 but downward in lead AVF
Right Axis Deviation: Downward in Lead 1 but upward in AVF
Intervals:
Normal: PR interval between 120-200
AV Block: PR interval>200 or P with no QRS
LBBB: QRS duration increased, no R wave in V1,
RBBB: QRS duraction increased. RSR complex. Rabbit ears in lead 1
Ischemia: Inverted T waves
Chamber enlargement:
R atrial abnormality: The p wave in lead II is larger
L atrial abrnomality: p wave width is greater
LVH: amplitude of S in V1+R in V5 or V6 is>35mm