ECG Guru - Instructor Resources - Normal 12-lead ECG https://www.ecgguru.com/ecg/normal-12-lead-ecg-1 en Normal 12-Lead ECG https://www.ecgguru.com/ecg/normal-12-lead-ecg <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/normal-12-lead-ecg"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/N%20106%20subtle%20ST%20ch.jpg" width="1800" height="1381" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>This ECG is nearly completely normal. &nbsp;We say "nearly" because there are VERY subtle changes which may or may not be chronic. &nbsp;Unfortunately, we know nothing about this patient's history or circumstances except age, gender, and race, and the fact that she was an Emergency Department patient. &nbsp;If she presented with chest pain, the ECG might be viewed completely differently than if she presented with a fever.</p><p>So, first, let's look at what is within NORMAL range. &nbsp;Most of these characteristics will be readily seen by your BASIC LEVEL students. &nbsp;The rate and intervals are within normal ranges. &nbsp;The rhythm is normal sinus rhythm. &nbsp;There is good R wave progression in the precordial leads. &nbsp;That is, V1 is primarily negatively-deflected and V6 is positive, with Leads V2 through V5 gradually becoming more and more positive. &nbsp;The frontal plane axis is within normal range - Leads I and II are positive. &nbsp;This would be a suitable ECG to use when introducing beginning students to the 12-lead ECG.</p><p>As for what is NOT NORMAL, there are several subtle characteristics. &nbsp;First, the P waves are slightly tall and have a pointed appearance. &nbsp;The P wave in V1 is biphasic. &nbsp;This can represent P PULMONALE, a sign of right atrial strain. &nbsp;This is often seen with pulmonary disease. &nbsp;One might also expect to see a shift of the frontal plane axis to the right if there is right ventricular hypertrophy as a result of increased strain on the right heart, but here we see a subtle shift to the left. &nbsp;The axis is still within normal limits, but at 17 degrees, it is closer to the left than the right.</p><p>The ST segments here are not perfect. &nbsp;One could argue that there is VERY slight elevation in Leads I and aVL, and the shape of the ST in V1 is coved upward. &nbsp; Lead III's ST segment is flat, and the T wave is inverted. &nbsp;Without clinical corelation, it is impossible to determine the importance of these changes. &nbsp;It is a good discussion to have with your more advanced students.</p><p>As said, it would be MUCH easier to ascribe meaning to these changes if we knew something of the patient's chief complaint, symptoms, and history.</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/667/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Normal 12-Lead ECG 1/5</option><option value="40">Give Normal 12-Lead ECG 2/5</option><option value="60">Give Normal 12-Lead ECG 3/5</option><option value="80" selected="selected">Give Normal 12-Lead ECG 4/5</option><option value="100">Give Normal 12-Lead ECG 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.7</span></span> <span class="total-votes">(<span >3</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-jvaGxN4NQEEiRTrXGXkOGQptcZ2k-Oe-u2GtHJbFRZs" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/normal-sinus-rhythm" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal sinus rhythm</a></div><div class="field-item odd"><a href="/ecg/axis" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Axis</a></div><div class="field-item even"><a href="/ecg/normal" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal</a></div><div class="field-item odd"><a href="/ecg/p-pulmonale" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">P pulmonale</a></div><div class="field-item even"><a href="/ecg/normal-12-lead-ecg-1" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal 12-lead ECG</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fnormal-12-lead-ecg&amp;title=Normal%2012-Lead%20ECG"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Sun, 16 Aug 2015 16:13:52 +0000 Dawn 656 at https://www.ecgguru.com https://www.ecgguru.com/ecg/normal-12-lead-ecg#comments ECG Basics: Normal 12-Lead ECG https://www.ecgguru.com/ecg/ecg-basics-normal-12-lead-ecg <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics-normal-12-lead-ecg"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/110%20%20Normal%2012%20Ld.jpg" width="1544" height="1198" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>Up until now, we have posted basic rhythm strips in this area of the ECG Guru for those of you who are teachers of beginning students. &nbsp;Today, we offer a "normal" 12-Lead ECG for those desiring to introduce students to the 12-Lead format. &nbsp;It is always best to become familiar with normal before venturing into the realm of "abnormal". &nbsp;Encourage your students to find what they know to be normal, then add to their knowledge. &nbsp;Examples of findings which are within normal limits are: &nbsp;rate, rhythm, P wave morphology, QRS morphology, intervals, axis, R wave progression, ST segments, and T wave direction.&nbsp;</p><p>While advanced practitioners can almost always find something that is not "normal", we must remember that that can be said about almost any human body. &nbsp;This ECG was taken from a healthy volunteer with no medical complaints.</p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/667/feed" method="post" id="fivestar-custom-widget--2" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--4" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give ECG Basics: Normal 12-Lead ECG 1/5</option><option value="40">Give ECG Basics: Normal 12-Lead ECG 2/5</option><option value="60">Give ECG Basics: Normal 12-Lead ECG 3/5</option><option value="80" selected="selected">Give ECG Basics: Normal 12-Lead ECG 4/5</option><option value="100">Give ECG Basics: Normal 12-Lead ECG 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >3.5</span></span> <span class="total-votes">(<span >4</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--2" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-T1wk4as1KqZKskZ9BwuaxPCKfUnIajCOjDkRWzd-vFA" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/ecg-basics" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">ECG Basics</a></div><div class="field-item odd"><a href="/ecg/basic-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Basic ECG</a></div><div class="field-item even"><a href="/ecg/normal" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal</a></div><div class="field-item odd"><a href="/ecg/normal-12-lead-ecg-1" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal 12-lead ECG</a></div><div class="field-item even"><a href="/ecg/normal-sinus-rhythm" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal sinus rhythm</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_2"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fecg-basics-normal-12-lead-ecg&amp;title=ECG%20Basics%3A%20%20Normal%2012-Lead%20ECG%20"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Wed, 07 Aug 2013 19:14:07 +0000 Dawn 480 at https://www.ecgguru.com https://www.ecgguru.com/ecg/ecg-basics-normal-12-lead-ecg#comments