Szombath D.Tornci L.

: EKG workbook
All tracings
This study aid has been prepared for classroom projection and
not for printing. If you need a paper copy, you can by the one
published by Semmelweis Kiad. The quality of this is far
superior than what you can get by printing it yourself.
Dr. Szombath Dezs, Dr. Tornci Lszl, 2005
Reproduction of this material in any form is allowed only by
written permission by the editors and Semmelweis Kiad.
September 13, 2006.
Click on the selected item in the contents to get to the ECG you want.
You can get back to the contents page by clicking on the page number.
E01 Normal ECG
E02 Normal tracing (mean axis 45) + sinus tachycardia
E03 Normal tracing, right deviation (mean axis 80)
E04 Normal tracing, left deviation (mean axis 10) + sinus bradycardia,
flat T waves
E05 Effect of respiration on the mean axis (030). The positional Q
wave disappears during inspiration.
E06 Sinus tachycardia, frequency: 120/min
E07 Sinus bradycardia, frequency: 50/min
E08 Respiratory sinus arrhythmia (mean axis 90, right deviation)
E09 Sinus arrest, junctional escape beat
E10 Sick Sinus Syndrome: sinus bradycardia, intermittent atrial flutter
with AV block
E11 Atrial premature contractions (APCs) with variable PR interval and
aberrant conduction
E12 Multifocal atrial tachycardia
E13 Atrial fibrillation, aberrantly conducted ventricular complexes,
tachyarrhythmia
E14 Atrial fibrillation, absolute arrhythmia
E15 Atrial flutter
E16 Junctional (or atrial) premature contractions in a 4:1 (quadrigeminy)
pattern
E17 Junctional escape rhythm (mesonodal beats), frequency 40/min
E18 Accelerated junctional rhythm, (inverted P waves precede the QRSs)
E19 Accelerated junctional rhythm, (inverted P waves come after the
QRSs)
E20 Junctional tachycardia (reentry), frequency 150/min
E21 Ventricular bigeminy (2:1)
E22 Fully compensated ventricular premature contractions (VPCs, 3:1 =
trigeminy)
E23 Fully compensated ventricular premature contractions (VPCs, 4:1 =
quadrigeminy), sinus tachycardia
E24 Short runs of VPCs
E25 Nonsustained ventricular tachycardia following bigeminy
E26 Runs of ventricular tachycardia with signs of retrograde conduction
to the atria
E27 Ventricular tachycardia
E28 Ventricular tachycardia
E29 Long QT syndrome (QT = 0.56 s, Qtc = 0.50 s)
E30 Torsade de pointes type polymorphic ventricular tachycardia
E31 Ventricular flutter
E32 Ventricular flutter, fibrillation and cardiac arrest
E33 Ventricular parasystole with fusion beats
E34 First degree atrioventricular (AV) block (PR 0.33 s)
E35 Second degree AV block, Wenckebach type (Mobitz I) with a 4:3
conduction ratio. Progressive shortening of the RR interval is seen in
the first cycle.
E36 Second degree AV block, Mobitz II
E37 Second degree AV block, with 2:1 conduction ratio
E38 Third degree AV block
E39 Third degree AV block, ventricular escape rhythm
E40 High grade AV block. The first QRS is a fusion beat, the fourth is a
capture.
E41 Second degree sinuatrial (SA) block (Mobitz I)
E42 Second degree SA block (Mobitz II)
E43 Complete right bundle branch block (RBBB) (QRS 0.12 s)
E44 Complete left bundle branch block (LBBB) (QRS 0.12 s)
E45 Rate dependent LBBB
E46 Left anterior fascicular block (hemiblock, mean axis 50), APC
Contents
E47 Right ventricular hypertrophy (mean axis 100), first degree AV
block
E48 Left posterior hemiblock, incomplete RBBB
E49 Ventricular preexcitation, Wolff-Parkinson-White (WPW) syndrome
E50 WPW syndrome, tachycardia with wide QRS complexes, junctional
escape beat, sinus rhythm
E51 Alternating WPW complexes
E52 Short PR, narrow QRS, APC, left anterior hemiblock
E53 Hypokalemia
E54 Hyperkalemia
E55 Signs of digitalis effect
E56 Signs of left ventricular strain
E57 Left ventricular hypertrophy
E58 Right ventricular hypertrophy
E59 Left atrial abnormality (P mitrale)
E60 Left atrial abnormality (P mitrale), right deviation
E61 Right atrial abnormality (P pulmonale)
E62 Subendocardial ischemia
E63 Hyperacute extensive anterior infarct, R-reduction. Mirror images in
the inferior leads.
E64 Acute extensive anterior and lateral infarction. Mirror images in the
inferior leads. P pulmonale
E65 Acute anterolateral infarction
E66 Anterior infarction (R reduction in V3), sinus tachycardia, scooped
ST
E67 Subacute anterior infarction
E68 Subacute lateral infarction
E69 Hyperacute, high lateral infarction
E70 Hyperacute inferior and posterior infarction
E71 Acute inferior infarct recorded at different time points
E72 Old inferior infarction
E73 Inferior and posterior infarction
E74 Subacute posterior infarction
E75 Acute inferior, posterior, and lateral infarction
E76 Extensive anterior non-Q infarction (NQMI)
E77 Hyperacute inferior infarction, atrial fibrillation
E78 Acute extensive anterior infarction, atrial fibrillation
E79 Subacute anterior and old inferior infarction, first degree AV block
E80 Hyperacute inferior infarction, second degree AV block (Mobitz I)
E81 Acute inferior infarction, second degree AV block (Mobitz I)
E82 Acute inferior infarction, second degree AV block (2:1)
E83 Hyperacute inferior infarction, third degree AV block with junctional
escape rhythm
E84 Acute anterior infarction, RBBB, sinus tachycardia
E85 Acute anterolateral infarction, complete LBBB
E86 ECG of a patient with acute pericarditis
E87 Acute overload of the right ventricle (cor pulmonale acutum, SIQIII
pattern), first degree AV block
E88 Cerebral T waves caused by intracranial hemorrhage. Long QT
syndrome (QT = 0.46 s, Qtc = 0.52 s)
E89 Pacemaker rhythm (LBBB pattern the electrode is in the right
ventricle)
E90 ECG of a patient with a dual chamber (atrial and ventricular)
pacemaker
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
II
III
I
25 mm/s, 10 mm/mV
E01
25 mm/s, 10 mm/mV
aVR
aVL
aVF
II
III
I
V1
V2
V3
V4
V5
V6
E02
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E03
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E04
25 mm/s, 10 mm/mV
belgzs/inspiration
II
III
I
E05
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E06
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E07
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E08
25 mm/s, 10 mm/mV
aVL
E09
25 mm/s, 10 mm/mV
II
III
I
V1
V2
V3
aVR
aVL
aVF
V4
V5
V6
The labels aVR-aVL-aVF and V1-V2-V3 are mixed up in the paper version of the workbook.
E10
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
25 mm/s, 10 mm/mV
E11
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E12
25 mm/s, 10 mm/mV
II
III
I
E13
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E14
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E15
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V3
V5
V6
E16
25 mm/s, 10 mm/mV
II
III
I
II
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E17
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E18
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
E19
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
E20
25 mm/s, 10 mm/mV
II
III
I
E21
I
25 mm/s, 10 mm/mV
E22
II
III
I
25 mm/s, 10 mm/mV
E23
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E24
25 mm/s, 10 mm/mV
II
I
aVF
V2
V6
E25
25 mm/s, 10 mm/mV
II
III
I
E26
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
V1
E27
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
aVL
E28
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
The lead labels are missing in the paper version of the workbook.
E29
II
I
V1
25 mm/s, 20 mm/mV
E30
25 mm/s, 10 mm/mV
II
III
I
II
III
I
E31
I
I
I
I
I
I
25 mm/s, 10 mm/mV
E32
I
I
25 mm/s, 10 mm/mV
E33
25 mm/s, 10 mm/mV
I
E34
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
E35
25 mm/s, 10 mm/mV
II
E36
25 mm/s, 10 mm/mV
II
III
I
E37
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
E38
25 mm/s, 10 mm/mV
I
V1
V1
E39
25 mm/s, 10 mm/mV
I
E40
25 mm/s, 10 mm/mV
II
E41
25 mm/s, 10 mm/mV
I
E42
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E43
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E44
25 mm/s, 10 mm/mV
I
E45
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
E46
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
E47
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E48
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E49
25 mm/s, 10 mm/mV
II
III
I
E50
25 mm/s, 10 mm/mV
II
III
I
aVF
V1
V6
E51
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E52
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E53
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E54
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E55
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E56
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E57
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E58
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E59
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E60
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1
E61
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E62
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E63
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E64
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E65
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E66
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E67
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E68
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E69
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E70
25 mm/s, 10 mm/mV
16:46 h
19:13 h
II
III
I
II
III
I
aVR
aVL
aVF
aVR
aVL
aVF
V1
V2
V3
V1
V2
V3
V4
V5
V6
V4
V5
V6
E71
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E72
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
II
E73
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
V7
V8
V9
VD1
VD2
VD3
25 mm/s, 10 mm/mV
E74
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E75
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E76
25 mm/s, 10 mm/mV
II
III
I
E77
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
25 mm/s, 10 mm/mV
E78
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E79
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
aVF
E80
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
E81
25 mm/s, 10 mm/mV
II
III
I
aVR aVL aVF
E82
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
E83
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E84
25 mm/s, 10 mm/mV
II
III
I
aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E85
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E86
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E87
25 mm/s, 10 mm/mV
II III I
aVR aVL aVF
V1 V2 V3
V4 V5 V6
E88
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
E89
25 mm/s, 10 mm/mV
II
III
I aVR
aVL
aVF
V1
V2
V3
V4
V5
V6
II
E90