A Systematic Approach to Electrocardiogram (ECG, EKG) Interpretation by Using 2 Mnemonics

Author: V. Dimov, M.D. Published in theProceedings of the 3rd Annual Cleveland Clinic Perioperative Medicine Summit, CCJM.This is a 2-step approach remembered by 2 mnemonics:Step 1: Evaluate all elements of the EKG systematically:A RARE PQRST.Step 2: Differential diagnosis. Look for diseases that may have caused the abnormalities noted in step 1:DR III EEE !This systematic approach to reading electrocardiograms (ECGs or EKGs) works every time, just like a machine. By using it, you will not miss any major abnormalities in electrocardiograms (EKGs).What is the meaning of the mnemonics?A RARE PQRST:Age, e.g. a 60-yo patient is likely have a different pathology from a 30-yo patientRate, e.g. fast or slow?Axis, e.g. left or right?Rhythm, e.g. regular or irregular?Evaluate each EKG element as follows:P wave, e.g. peaked or absent?PR interval - short or prolonged?Q wave, e.g. deep Q wave?QT inerval - - short or prolonged?R wave, e.g. tall? look at QRS complex width for RBBB or LBBBST segment, e.g. elevation or depression?T wave, e.g. peaked or inverted? U wave?DR IIIEEE:Drugs , e.g. Digoxin, tricyclic antidepressantsRhythm and rate abnormalities, e.g. AV block of 1,2,3 degree, AFib, SVT? Interval prolongation?Ischemia?Infarct? Deep Q wave?Infection, e.g. pericarditisEnlargement, e.g. LVH, RVH, left or right atrium enlargement?Electrolyte disturbances, e.g. hyperkalemia, hypokalemia, hypercalcemia,Endocrine causes, e.g. hypothyroidismHow to use this approach in practice?Look at the E...
Source: Clinical Cases and Images - Category: General Medicine Tags: Cardiology Source Type: news