12 lead reading

Question 1

Septal/Anterior

Answer 1

V1, V2

If there’s severe depression in v1 and v2, consider posterior wall MI

Question 2

Anterior

Answer 2

V1, V2, V3, V4

Reciprocal 2, 3, aVF

Question 3

Lateral

Answer 3

V5, V6, 1, aVL

Reciprocal 2, 3, aVF

Question 4

Normal Sinus

Answer 4

Btw 60-100
Equal
P waves present equal
PR Interval is between 0.12-0.20 sec
QRS less than 0.12 sec

Question 5

Inferior

Answer 5

2, 3, AVF

Reciprocal: 1, aVL

Question 6

MONA

Answer 6

Morphine
Oxygen
Nitro
ASA

Question 7

Pericarditis

Answer 7

Pericarditis is an inflammation of the pericardium (the fibrous sac surrounding the heart). A characteristic chest pain is often present

ST segment elevations in all leads except aVR and V1 and PR segment-depression possible in any lead except aVR

Smiley face

Question 8

LVH

Answer 8

Deepest S in V1 and V2 + Tallest R in V5 or V6 (whichever is larger) ≥ 35 mm (≥ 7 large squares)

Question 9

Qtc

Answer 9

Qtc

Question 10

Scarbossa Criteria

Answer 10

Concordant ST elevation > 1mm in leads with a positive QRS complex (score 5)

Concordant ST depression > 1 mm in V1-V3 (score 3)

Excessively discordant ST elevation > 5 mm in leads with a negative QRS complex (score 2). This criterium is sensitive, but not specific for ischemia in LBBB. It is however associated with a worse prognosis, when present in LBBB during ischemia.