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Instructors' Collection ECG: Normal Adult 12-Lead ECG

Submitted by Dawn on Sun, 12/22/2024 - 18:12

From time to time, we like to publish an ECG that is "within normal limits".  While ECGs each look slightly different, there are defined parameters that are considered to be normal.  Using the taxonomy terms in the Scrollable List provided on this site, you can easily find and compare the "normal" ECGs.  This is taken from a 45-year-old male with a lean body type.

A few of the characteristics that make this ECG normal include, but are not limited to:

*  Rate 85 bpm.  Rhythm regular.  P waves present before QRS complexes.  NORMAL SINUS RHYTHM.

*  All intervals within normal limits, including a narrow QRS.

*  No pathological ST segment elevations, depressions, or Q waves.

*  Frontal plane axis is normal. Slightly early R wave transition in the precordial leads.

*  No ectopic beats or pauses.

It is very important for students to become familiar with normal ECG characteristics before they learn abnormalities.  The normal features become a "template" for the interpreter to compare abnormal ECGs to.

 

Our thanks to David Morris, Palm Beach County Fire Rescue, for the donation of this ECG.

Dawn's picture

Normal ECG in Seven-year-old Girl

Submitted by Dawn on Fri, 12/07/2018 - 14:44

The Patient:   This ECG was obtained from a seven-year-old girl who was complaining of mild, non-specific chest pain.  A medical workup found no structural or electrical abnormalities, and her pain resolved without treatment.  This is a good ECG to illustrate some of the ECG findings that are normal at this age, which might not be normal in adults or in infants.

The ECG: A general description of this ECG would include:

·         Normal sinus rhythm at 87 bpm

·         Normal frontal plane QRS axis at 60 degrees

·         PR interval:  .132 second (132 ms)

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Normal 12-Lead ECG With Rhythm Strips

Submitted by Dawn on Thu, 05/12/2016 - 13:03

Occasionally, we like to feature a normal ECG.  It is important to start with the characteristics of the  normal ECG when learning to recognize “abnormal”.  Of course, there are many variations in ECGs considered to be normal.  Once a student recognizes the features of the normal ECG, it becomes possible to recognize “abnormal” and then learn the clinical ramifications of the abnormalities. 

This strip includes a 12-lead ECG in standard format, as well as three rhythm strips in Leads V1, II, and V5. All six channels are run simultaneously, so it is easy to compare one heartbeat in multiple leads. 

NORMAL FEATURES

What are the features of this ECG that make it “normal”?  It is a combination of features the ECG has, and features it does NOT have.  Normal findings include:

 

*  Normal sinus rhythm.  The rhythm is regular, the rate is 80 bpm, and there is a P wave before every QRS complex.  The P waves all look alike in each lead, and they are upright in the inferior leads (II, III, and aVF).

*  The intervals are within normal limits.  The PR interval is about .16 sec. (160 ms), the QRS complexes are narrow, and the QT interval is about 320 ms.

*  The ST segments are not elevated or depressed.  The T waves are upright, except in Leads III and aVR. Negative T waves are normal in these leads.  The shape of the ST segments is concave upward, “smiling”.

*  The frontal plane axis is within normal limits.  It is slightly to the left of the center of normal, making Lead I taller than Lead II.  But, when Lead II is positive, the axis is normal.

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