How to read ECG for Beginners?

How to read ECG for Beginners?

1.    First you should look at Rhythm is t steady or not? To look at rhythm you measure the R and the next R waves if they are equal then the rhythm is steady.

2.    Calculate Heart rate: one of the most important things to do but How? It's easy by counting the large squares between R-R interval then do the calculation
Heart rate = 300/Number of large squares.

 

Heart rate abnormalities:
If the sum of calculation is less than 60 beats/minute then the patient has bradycardia
If Heart rate more than 100 the patient has tachycardia

3.    Examine the waves P,QRS,T is they are normal or inverted or absent

4.    Check P-R interval normal it is 3-4 small squares or .04 seconds.

5.    Detect the mean electrical axis: refers to the net ventricular depolarization direction.

How to calculate MEA by calculate net deflection of QRS complex in the LEAD I and aVF
Net deflection is QRS is net Positive or net Negative or isoelectric. Calculate it by substract Down waves from up waves.

Normally the QRS is positive in LEAD I and aVF and the MEA is between -30 and 110 but there is some abnormalities which causes:

Right axis deviation - QRS is Negative in LEAD I and Positive in aVf the axis between 0 and -90 -as

• right heart hypertrophy or dilation
• Conduction defect of right ventricle
• Acute myocardial infarction of left side of the heart

Left axis deviation – QRS is positive in LEAD I and Negative in aVf the axis between 0 and -90 - as

• left heart hypertrophy or dilation
• Conduction defect of left ventricle except for posterior bundle branch
• Acute myocardial infarction of right side of the heart

How to use our calculator?

CVS  chart and cardiovascular calculator can be used to estimate Cardiovascular risk of given time period on charts which based on Joint British society and British National formula researchers. we provide also a smiley face and bar graphs which may be useful for some people.

Different equations
our calculator and chart can make risk values according to many equations like Framingham equation used by the Joint British Societies (JBS) which is derived from Framingham, and the Scottish ASSIGN score. Current guidelines recommend stratification based on the probability of cardiovascular disease. We recommend using JBS formula.

Framingham
the most equation used by people to calculate the risk of CVS disease, it gives patient advantage to use different ages for different outcomes: like CVS, Stroke, coronary disease or MI
JBS the official calculator published by British National formulary. on our site the BNF calculator designed to provide a close result as possible to Official charts. LVH and Diabetes risk factor aren't included in JBS and patient are considered high risk.

Assign
it is the score developed by Scottish Intercollegiate Guidelines Network to handle with issues that Framingham equation can't calculate its mainly designed for Scottish populations

The outcome

• CVD (BNF) - risk of developing cardiovascular disease, based on the calculation used by JBS/BNF. This option may be used to produce charts similar to those produced by the JBS. 
• CVD (ASSIGN) - risk of developing cardiovascular disease, based on the ASSIGN calculation. 
• CVD (Framingham) - risk of developing cardiovascular disease, based on the original Framingham equation. 
• CHD - risk of developing coronary heart disease (MI, CHD death, angina, coronary insufficiency), based on Framingham. 
• MI - risk of suffering a myocardial infarction (a "heart attack"), based on Framingham. Stroke - risk of suffering a stroke (including transient ischaemic events (TIAs), based on Framingham.
• CVD death - risk of dying from cardiovascular disease, based on Framingham. 
• CHD death - risk of dying from coronary heart disease, based on Framingham.

Calculate Ischemic heart disease risk factor in next 10 years

• Chart style
• BNF charts
• Comparison bars
• Thermometer

Calculate risk of CVD (BNF)CVD (ASSIGN)CVD (Framingham)CHDMIStrokeCVD deathCHD death

Time period  years Time period 10 years

Age years

Male

Smoker Cigarettes per day Diabetes Family history LVH (strict Framingham criteria)

Postcode or SIMD

Systolic Blood Pressure mmHg

Cholesterol
Total : HDL mmol/L

Use pre-treatment BP/cholesterol values

How to read ECG for Beginners?

How to read ECG for Beginners?

1.    First you should look at Rhythm is t steady or not? To look at rhythm you measure the R and the next R waves if they are equal then the rhythm is steady.

2.    Calculate Heart rate: one of the most important things to do but How? It's easy by counting the large squares between R-R interval then do the calculation
Heart rate = 300/Number of large squares.

 

Heart rate abnormalities:
If the sum of calculation is less than 60 beats/minute then the patient has bradycardia
If Heart rate more than 100 the patient has tachycardia

3.    Examine the waves P,QRS,T is they are normal or inverted or absent

4.    Check P-R interval normal it is 3-4 small squares or .04 seconds.

5.    Detect the mean electrical axis: refers to the net ventricular depolarization direction.

How to calculate MEA by calculate net deflection of QRS complex in the LEAD I and aVF
Net deflection is QRS is net Positive or net Negative or isoelectric. Calculate it by substract Down waves from up waves.

Normally the QRS is positive in LEAD I and aVF and the MEA is between -30 and 110 but there is some abnormalities which causes:

Right axis deviation - QRS is Negative in LEAD I and Positive in aVf the axis between 0 and -90 -as

• right heart hypertrophy or dilation
• Conduction defect of right ventricle
• Acute myocardial infarction of left side of the heart

Left axis deviation – QRS is positive in LEAD I and Negative in aVf the axis between 0 and -90 - as

• left heart hypertrophy or dilation
• Conduction defect of left ventricle except for posterior bundle branch
• Acute myocardial infarction of right side of the heart