EKG WORKBOOK

PHYSICIAN CORE 2013

42 y/o woman in for pre employment physical

Rate
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Rhythm :________________
Axis
:________________

Other findings :_________________________________

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35 y/o weekend athlete with a broken leg

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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63 y/o with no complaints and routine EKG in PMDs office

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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67 y/o man with history of hyperlipidemia, DM, & HTN

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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73 y/o man with dizzyness

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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59 y/o man hx htn and etoh abuse presents to ER c/ SOB

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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63 y/o man with lung ca c/o of palpitations

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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57 y/o man with hx HTN, TOB & COPD

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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Criteria for RBBB

The heart rhythm must originate above the ventricles (i.e.
sinoatrial node, atria or atrioventricular node) to activate
the conduction system at the correct point.
The QRS duration must be more than 100 ms (incomplete
block) or more than 120 ms (complete block)
There should be a terminal R wave in lead V1 (e.g. R, rR',
rsR', rSR' or qR)
There should be a slurred S wave in leads I and V6.
The T wave should be deflected opposite the terminal
deflection of the QRS complex. This is known as
appropriate T wave discordance with bundle branch block.
A concordant T wave may suggest ischemia or myocardial
infarction.

73 y/o woman hx HTN, CRI, DM presents c/o neck fullness

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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Criteria for LBBB

The heart rhythm must be supraventricular in
origin
The QRS duration must be 120 ms[2]
There should be a QS or rS complex in lead V1
There should be a RsR' wave in lead V6.
The T wave should be deflected opposite the
terminal deflection of the QRS complex. This is
known as appropriate T wave discordance with
bundle branch block. A concordant T wave may
suggest ischemia or myocardial infarction

63 y/o man with hx htn, hyperlipid, c/o 4 hrs sscp & sob

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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69 y/o man c/ no known pmhx c/o 2 hrs crushing cp

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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75 y/o woman c/dm, htn, c/o epigastric discomfort

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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73 y/o woman with prior hx of syncope

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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41 y/o man with hx borderline HTN and cocaine

Rate :________________
Rhythm :_____________
Axis :________________

Other findings :______________________________

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Criteria for LVH

The Sokolow Lyon index:
S in V1 + R in V5 or V6 (whichever is larger) 35 mm ( 7
large squares)
R in aVL 11 mm
The Cornell voltage criteria for the ECG diagnosis of
LVH involve measurement of the sum of the R wave in
lead aVL and the S wave in lead V3. The Cornell criteria
for LVH are:
S in V3 + R in aVL > 28 mm (men)
S in V3 + R in aVL > 20 mm (women)