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Lead Groupings
Inferior Leads
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Lead Groupings
Septal Leads
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Lead Groupings
Anterior Leads
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Lead Groupings
Lateral Leads
- I, aVL (Top)
- V5, V6 (Middle)
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What is the steps to the systematic approach to reading a 12-Lead?
- Baseline ECG (Normally Lead II)
- Axis Determination
- Hemiblocks
- Bundle Branch Blocks
- V-Tach determination
- Assess for Infarct (I See All Leads)
- Final Diagnosis
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Normal Axis Determination in I, II, III
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Left Physiological Axis Determination
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Left Pathological Axis Determination
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Extreme Right Axis Determination
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What is the "Turn Signal Rule"?
- J Point, points up - Right BBB
- J Point, Points down - Left BBB
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3- MI Pitfalls in 12-Lead Interpretation
- LBBB
- Left Ventricular Hypertrophy
- Pericarditis
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How do you determine Left Ventricular Hypertorphy (LVH)
- The R wave in lead aVL is taller than 12mm or
- Rule of 35
- Rule of 53
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What is the Rule of 35/53?
- Look at the tallest R wave in V4, V5, or V6
- Add the total mm of R wave to Deepest S wave in V1, V2, or V3
- If the total is >35 and the Pt is >35 it is LVH
- If <35 yo, use rule of 53
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How do you determine Pericarditis?
- ST Elevation in most leads
- Pt. will feel better when leaning forward
- No ST Depression
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What factors determine true V-Tach on a 12-Lead?
- Fast Rate
- Leads I, II, and III all Down? Yes V-Tach
- Is V1 Up? Yes V-Tach
- Is V6 Down? Yes V-Tach
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What does "I See All Leads" the acronym for?
- I-Inferior
- S- Septal
- A- Anterior
- L- Lateral
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Deviations in leads II, III and aVF
Inferior MI
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Deviations in leads V1 and V2
Septal
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Deviations in leads V3 and V4
Anterior
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Deviations in leads V5, V6, I, aVL
Lateral
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