Criterias on ECG

Question 1

P-pulmonale criteria

Answer 1

This can be seen as increased amplitude of the first portion of P wave (Beyond 2.5mm in V1) or as right axis deviation (Which may lead to tallest P wave appearing in leads aVF or even III).

Question 2

P-mitrale

Answer 2

The diagnosis of left atrial enlargement requires that the terminal portion of the P wave in V1 should either drop more than 1 small box below isoelectric line (Increased amplitude) or be more than 1 small box in duration (increased duration).

Question 3

Right ventricular hypertrophy

Answer 3

Disruption of R-wave progression

• In lead V1, the R wave is larger than the S wave
• In lead V6, the S wave is larger than the R wave

Question 4

Precordial criteria for LVH

Answer 4

1. The R-wave in lead V5 or V6 + The S wave in lead V1 or V2 exceeds 35mm
2. The R-wave in lead V5 exceeds 26mm
3. The R-wave in lead V6 exceeds 20mm
4. The R-wave in lead V6 exceeds the R-wave in lead V5

Question 5

Limb lead criteria for LVH

Answer 5

1. The R-wave in lead aVL exceeds 11mm
2. The R-wave in lead I exceeds 13mm
3. The R-wave in lead aVF exceeds 20mm
4. The R-wave in lead I + the S-wave in lead III exceeds 25mm

Question 6

First degree AV block criteria

Answer 6

PR interval longer than 0.2 seconds

Question 7

RBBB criteria

Answer 7

1. QRS complex widened to greater than 0.12 seconds
2. RSR´(rabbit ears) or a tall R wave in V1 and V2 with ST-segment depression and T-wave inversion
3. Reciprocal late deep S waves in left lateral leads (I, aVL, V5 and V6)

Question 8

LBBB criteria

Answer 8

1. QRS complex widened to greater than 0.12 seconds
2. Broad or notched R wave with prolonged upstroke in left lateral leads (I, aVL, V5 and V6), with ST-segment depression and T-wave inversion
3. Reciprocal broad, deep S waves in V1 and V2
4. Left axis deviation may be present

Question 9

Left anterior hemiblock criteria

Answer 9

1. Normal QRS duration and no ST-segment or T-wave changes
2. Left axis deviation between -30 and -90 degrees
3. No other cause of left axis deviation is present

Question 10

Left posterior Hemiblock

Answer 10

1. Normal QRS duration and no ST-segment or T-wave changes
2. Right axis deviation between +90 and 180 degrees
3. No other cause of right axis deviation is present

Question 11

WPW syndrome criteria

Answer 11

1. Short PR interval (less than 0.12 seconds)
2. Wide QRS complex
3. Delta waves

Question 12

ECG stages of STEMI

Answer 12

(1) T-wave peaking followed by T-wave inversion
(2) ST-segment elevation
(3) The appearance of new Q waves

Question 13

ST segment elevation criterias

Answer 13

• ST elevation in leads V2 or V3 more than 2.5mm in males younger than 40y, more than 2mm in males older than 40y and more than 1.5mm in females of all ages.
• ST elevation in all other leads is more than 1mm (in all ages and genders)
• Plus, the ST elevation must be present in at least two contiguous leads

Question 14

Hyperkalemia criteria

Answer 14

1. T-wave peaking
2. PR interval prolongation
3. P wave flattening
4. QRS widening

Question 15

Hypokalemia criteria

Answer 15

1. ST-segment depression
2. Flattening of the T wave with prolongation of the QT interval
3. Appearance of a U wave