Lateral Infarct Q waves
I, AvL, V5, V6
abnormal septal depolarization
Absent Q waves in aVL and I
What is irregularly irregular?
MI axis deviation
away from MI
Progression of transmural injury
Peaked T, T wave inversion, ST elevtion, Q wave
Torsades de pointes
Normal septal depolarization
Q waves in avL, I, V6
U wave (flattening of T)
Hypertrophy axis deviation
abnormal septal depolarization QRS > 0.12 sec V1 and V2 with wide S V5 and V6 with RSR'
which have absent P waves?
Atrial fibrillation, junctional rhythm, V tac and fib, premature ventricular contraction
Diffuse ST elevation
RAD, R1Q3 down up up
T wave inversion
ischemia in low o2 demand
increase R wave in V1 and V2
Atrial Hypertrophy Right
Peaked T waves in I, II, or III Biphasic P wave in V1
Alt. Ventricular repolarizattion - ST segment despression and T waves. St depression: ischemia in high oxygen demain (coronary insufficiency) T wave inversion: due to acute a. obstruction in low O2 demand.
Anterior Infarct Q waves
V1, V2, V3, V4
Inferior infarct Q waves
II, III, aVF
increased R waves in I, aVL, V5 and V6 or >11 in aVL, >12 in I, and >10 in aVF
Normal Septal Depolarization QRS>0.12 sec RSR' or M shape in V1 and V2 Slurred S in I, aVL, V5, V6
LAD Q1R3 Up, down, down, with RBBB
necrosis; significant if >0.4 wide or 1/4 height of QRS
what has no QRS
V fibrillation, asystole
Left Atrial Hypertrophy
But shape in I, II, or III Bisphasic P wave in V1
ischemia in high oxygen demand or subendocardial injury
what is the trick for BBB?
go to J point and think turn signal
ST depression in V1 and V2 Tall R, no Q