ECG Guru - Instructor Resources - Normal 12-Lead https://www.ecgguru.com/ecg/normal-12-lead en Normal ECG in Seven-year-old Girl https://www.ecgguru.com/ecg/normal-ecg-seven-year-old-girl <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/normal-ecg-seven-year-old-girl"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/N%20110%20Normal%20ECG%207%20yo%20F.jpg" width="1800" height="640" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p class="MsoNormal"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%; color: #00b050;">The Patient:</span></strong><span style="font-size: 12.0pt; line-height: 107%; color: #00b050;"><span style="mso-spacerun: yes;">&nbsp;&nbsp; </span></span><span style="font-size: 12.0pt; line-height: 107%;">This ECG was obtained from a seven-year-old girl who was complaining of mild, non-specific chest pain.<span style="mso-spacerun: yes;">&nbsp; </span>A medical workup found no structural or electrical abnormalities, and her pain resolved without treatment.<span style="mso-spacerun: yes;">&nbsp; </span>This is a good ECG to illustrate some of the ECG findings that are normal at this age, which might not be normal in adults or in infants.</span></p><p class="MsoNormal"><span style="font-size: 12.0pt; line-height: 107%; color: #00b050;">The ECG: </span><span style="font-size: 12.0pt; line-height: 107%;">A general description of this ECG would include:</span></p><p class="MsoListParagraphCxSpFirst" style="text-indent: -.25in; mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">Normal sinus rhythm at 87 bpm</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">Normal frontal plane QRS axis at 60 degrees</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">PR interval: <span style="mso-spacerun: yes;">&nbsp;</span>.132 second (132 ms) </span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">QRS duration:<span style="mso-spacerun: yes;">&nbsp; </span><span style="mso-spacerun: yes;">&nbsp;</span>.082 second (82 ms)</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">QTc:<span style="mso-spacerun: yes;">&nbsp; </span><span style="mso-spacerun: yes;">&nbsp;</span>.391 second (391 ms)</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">Predominantly negative V1 and positive V2</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">Slightly irregular rhythm with no apparent changes in P wave morphology</span></p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l0 level1 lfo1;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><em style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; line-height: 107%;">Very</span></em><span style="font-size: 12.0pt; line-height: 107%;"> subtle J point elevation in V1 through V3</span></p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l0 level1 lfo1;"><span style="font-size: 12.0pt; line-height: 107%;"><br /></span></p><p class="MsoNormal"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%; color: #00b050;">The Normal ECG in Children<span style="mso-spacerun: yes;">&nbsp;&nbsp; </span></span></strong><span style="font-size: 12.0pt; line-height: 107%;">It is not really possible to state exact parameters for pediatric ECGs by age alone.<span style="mso-spacerun: yes;">&nbsp; </span>ECG findings are affected by age, but also by race, gender, body size, and puberty.<span style="mso-spacerun: yes;">&nbsp; </span>There are some findings in <strong style="mso-bidi-font-weight: normal;">this ECG</strong> that can be considered to be normal for this child without being necessarily normal for an infant, or for an adult.</span></p><p class="MsoListParagraphCxSpFirst" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">The slightly irregular sinus rhythm is very common in children</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%;">T wave inversion in V1</span></strong><span style="font-size: 12.0pt; line-height: 107%;"> is normal for a 7-year-old. In infants older than one week, T waves are usually inverted in V1 – V3.<span style="mso-spacerun: yes;">&nbsp; </span>The right precordial T waves will become upright during early childhood, with V3 becoming upright before V2.</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%;">RSR’ pattern in V1 </span></strong><span style="font-size: 12.0pt; line-height: 107%;">resembles right bundle branch block without the QRS widening.</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%;">Tall R waves in mid-precordial leads </span></strong><span style="font-size: 12.0pt; line-height: 107%;">may appear to meet voltage criteria for LVH. However, there is no “strain” pattern in the ST segments.<span style="mso-spacerun: yes;">&nbsp; </span>In this example, there is also no left axis deviation and aVL has low voltage (normal).<span style="mso-spacerun: yes;">&nbsp; </span>This appearance of high voltage is due to the child’s small chest wall, which makes the heart’s voltage readily measurable by the surface leads. (The ECG, in general, is not the best way to diagnose LVH – imaging is much better).<strong style="mso-bidi-font-weight: normal;"></strong></span></p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%;">Slightly peaked (rather than rounded) P waves</span></strong><span style="font-size: 12.0pt; line-height: 107%;">, less than 3 mm in height.</span></p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l1 level1 lfo2;"><span style="font-size: 12.0pt; line-height: 107%;"><br /></span></p><p class="MsoNormal"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%;">Some findings that might be normal in a seven-year-old that are NOT present in this ECG include:</span></strong></p><p class="MsoListParagraphCxSpFirst" style="text-indent: -.25in; mso-list: l2 level1 lfo3;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">Ventricular or supraventricular ectopy<strong style="mso-bidi-font-weight: normal;"></strong></span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l2 level1 lfo3;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">Slightly rightward frontal plane axis<strong style="mso-bidi-font-weight: normal;"></strong></span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l2 level1 lfo3;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">Dominant R wave in V1 (although the R wave in V2 might be taller than expected in an adult).</span></p><p class="MsoListParagraphCxSpMiddle" style="text-indent: -.25in; mso-list: l2 level1 lfo3;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">Short PR interval and QRS duration.</span></p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l2 level1 lfo3;"><!--[if !supportLists]--><span style="font-size: 12.0pt; line-height: 107%; font-family: Symbol; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;"><span style="mso-list: Ignore;">·<span style="font: 7.0pt 'Times New Roman';">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><!--[endif]--><span style="font-size: 12.0pt; line-height: 107%;">PR interval variations.</span></p><p class="MsoListParagraphCxSpLast" style="text-indent: -.25in; mso-list: l2 level1 lfo3;"><span style="font-size: 12.0pt; line-height: 107%;"><br /></span></p><p class="MsoNormal"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%; color: #00b050;">References:<span style="mso-spacerun: yes;">&nbsp; </span></span></strong><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%;">For more information, go to:</span></strong></p><p class="MsoNormal" style="margin-bottom: .0001pt; line-height: normal;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt;"><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769212/#!po=1.06383">Heart</a>.<span style="mso-spacerun: yes;">&nbsp; </span>2005 Dec; 91(12):1626-1630.<span style="mso-spacerun: yes;">&nbsp; </span>Doi: [10.1136/hrt.2004.057307] </span></strong></p><p class="MsoNormal" style="margin-bottom: .0001pt; line-height: normal;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt;"><span style="mso-spacerun: yes;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span>PMCID:<span style="mso-spacerun: yes;">&nbsp; </span>PMC1769212</span></strong></p><p class="MsoNormal" style="margin-bottom: .0001pt; line-height: normal;"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt;"><a href="https://litfl.com/paediatric-ecg-interpretation-ecg-library/">Life In The Fast Lane</a><span style="mso-spacerun: yes;">&nbsp;&nbsp; </span>Paediatric ECG Interpretation</span></strong></p><p class="MsoNormal"><strong style="mso-bidi-font-weight: normal;"><span style="font-size: 12.0pt; line-height: 107%;">&nbsp;</span></strong></p><p class="MsoNormal"><strong style="mso-bidi-font-weight: normal;"><em style="mso-bidi-font-style: normal;"><span style="font-size: 12.0pt; line-height: 107%;">Many thanks to Alan Vinyets for donating this ECG to the ECG Guru.</span></em></strong></p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/47/feed" method="post" id="fivestar-custom-widget" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--2" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Normal ECG in Seven-year-old Girl 1/5</option><option value="40">Give Normal ECG in Seven-year-old Girl 2/5</option><option value="60" selected="selected">Give Normal ECG in Seven-year-old Girl 3/5</option><option value="80">Give Normal ECG in Seven-year-old Girl 4/5</option><option value="100">Give Normal ECG in Seven-year-old Girl 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >2.9</span></span> <span class="total-votes">(<span >7</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-39gfiCtUlMIwDhkB6IZazwOlGA3-fl8cfYaG2M3tM70" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/normal" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal</a></div><div class="field-item odd"><a href="/ecg/normal-12-lead" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal 12-Lead</a></div><div class="field-item even"><a href="/ecg/pediatric-ecg" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Pediatric ECG</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_1"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fnormal-ecg-seven-year-old-girl&amp;title=Normal%20ECG%20in%20Seven-year-old%20Girl"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> <script type="text/javascript"> <!--//--><![CDATA[//><!-- if(window.da2a)da2a.script_load(); //--><!]]> </script></span></li> </ul> Fri, 07 Dec 2018 20:44:18 +0000 Dawn 762 at https://www.ecgguru.com https://www.ecgguru.com/ecg/normal-ecg-seven-year-old-girl#comments Normal 12-Lead ECG With Rhythm Strips https://www.ecgguru.com/ecg/normal-12-lead-ecg-rhythm-strips <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/normal-12-lead-ecg-rhythm-strips"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/N107.jpg" width="1800" height="1076" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p class="MsoNormal">Occasionally, we like to feature a normal ECG.&nbsp; It is important to start with the characteristics of the &nbsp;normal ECG when learning to recognize “abnormal”.&nbsp; Of course, there are many variations in ECGs considered to be normal.&nbsp; Once a student recognizes the features of the normal ECG, it becomes possible to recognize “abnormal” and then learn the clinical ramifications of the abnormalities.<span style="font-size: 13.008px; line-height: 1.538em;">&nbsp;</span></p><p class="MsoNormal">This strip includes a 12-lead ECG in standard format, as well as three rhythm strips in Leads V<sub>1</sub>, II, and V<sub>5</sub>.&nbsp;<span style="font-size: 13.008px; line-height: 1.538em;">All six channels are run simultaneously, so it is easy to compare one heartbeat in multiple leads.</span><span style="font-size: 13.008px; line-height: 1.538em;">&nbsp;</span></p><p class="MsoNormal"><strong><span style="color: #006600;">NORMAL FEATURES</span></strong></p><p class="MsoNormal"><strong></strong><span style="font-size: 13.008px; line-height: 1.538em;">What are the features of this ECG that make it “normal”?</span><span style="font-size: 13.008px; line-height: 1.538em;">&nbsp; </span><span style="font-size: 13.008px; line-height: 1.538em;">It is a combination of features the ECG has, and features it does NOT have.</span><span style="font-size: 13.008px; line-height: 1.538em;">&nbsp; </span><span style="font-size: 13.008px; line-height: 1.538em;">Normal findings include:</span></p><p class="MsoNormal">&nbsp;</p><p class="MsoNormal">*&nbsp; Normal sinus rhythm.&nbsp; The rhythm is regular, the rate is 80 bpm, and there is a P wave before every QRS complex.&nbsp; The P waves all look alike in each lead, and they are upright in the inferior leads (II, III, and aVF).</p><p class="MsoNormal">*&nbsp; The intervals are within normal limits.&nbsp; The PR interval is about .16 sec. (160 ms), the QRS complexes are narrow, and the QT interval is about 320 ms.</p><p class="MsoNormal">* &nbsp;The ST segments are not elevated or depressed.&nbsp; The T waves are upright, except in Leads III and aVR. Negative T waves are normal in these leads.&nbsp; The shape of the ST segments is concave upward, “smiling”.</p><p class="MsoNormal">*&nbsp; The frontal plane axis is within normal limits.&nbsp; It is slightly to the left of the center of normal, making Lead I taller than Lead II.&nbsp; But, when Lead II is positive, the axis is normal.</p><p class="MsoNormal">*&nbsp; R wave progression is correct in the precordial leads.&nbsp; The relative size of the R wave to the S wave in each lead is increasing as we progress from V<sub>1</sub> to V<sub>6</sub>.&nbsp; Therefore, V<sub>1</sub> is mostly negative, and V<sub>6</sub> is mostly positive.&nbsp; The change occurs in regular increments as we move to the patient’s left.&nbsp; This is indicative of correct lead placement as well as normal direction of depolarization.<strong style="font-size: 13.008px; line-height: 1.538em;">&nbsp;</strong></p><p class="MsoNormal"><strong><span style="color: #006600;">ABNORMAL FEATURES THAT ARE NOT PRESENT</span></strong></p><p class="MsoNormal"><strong></strong><span style="font-size: 13.008px; line-height: 1.538em;">*</span><span style="font-size: 13.008px; line-height: 1.538em;">&nbsp; </span><span style="font-size: 13.008px; line-height: 1.538em;">There are no ST elevations or depressions, and no pathological Q waves.</span></p><p class="MsoNormal">&nbsp;</p><p class="MsoNormal">*&nbsp; There is no QRS widening.&nbsp; There is no PRI or QT prolongation.</p><p class="MsoNormal">*&nbsp; There is no dysrhythmia.</p><p class="MsoNormal">*&nbsp; There are no signs of hypertrophy.<span style="font-size: 13.008px; line-height: 1.538em;">&nbsp;</span></p><p>&nbsp;</p><p class="MsoNormal"><strong>Remember, what constitutes “normal” has many variations.&nbsp; For example, a normal rate in an infant would be considered tachycardia in an adult.&nbsp;&nbsp;</strong></p></div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/47/feed" method="post" id="fivestar-custom-widget--2" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--4" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Normal 12-Lead ECG With Rhythm Strips 1/5</option><option value="40">Give Normal 12-Lead ECG With Rhythm Strips 2/5</option><option value="60" selected="selected">Give Normal 12-Lead ECG With Rhythm Strips 3/5</option><option value="80">Give Normal 12-Lead ECG With Rhythm Strips 4/5</option><option value="100">Give Normal 12-Lead ECG With Rhythm Strips 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="average-rating">Average: <span >2.7</span></span> <span class="total-votes">(<span >18</span> votes)</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--2" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-2S-0rIRVU28i8Ie9HI50x7R3k7W1lonDfy-Q59Sx-9Y" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/normal" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal</a></div><div class="field-item odd"><a href="/ecg/normal-12-lead" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal 12-Lead</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_2"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fnormal-12-lead-ecg-rhythm-strips&amp;title=Normal%2012-Lead%20ECG%20With%20Rhythm%20Strips"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Thu, 12 May 2016 19:03:50 +0000 Dawn 698 at https://www.ecgguru.com https://www.ecgguru.com/ecg/normal-12-lead-ecg-rhythm-strips#comments Normal 12-Lead ECG https://www.ecgguru.com/ecg/normal-12-lead-ecg-0 <div class="field field-name-field-ecg field-type-image field-label-hidden"><div class="field-items"><div class="field-item even"><a href="/ecg/normal-12-lead-ecg-0"><img typeof="foaf:Image" src="https://www.ecgguru.com/sites/default/files/N100.jpg" width="1400" height="520" alt="" /></a></div></div></div><div class="field field-name-field-ecg-interpretation field-type-text-long field-label-hidden"><div class="field-items"><div class="field-item even"><p>Sometimes, when teaching a class, it can actually be a challenge to find a good example of "normal" for your students.&nbsp; We all tend to collect the ECGs that are "interesting" or unusual.&nbsp; It is very important for students to fully recognize "normal" before they can appreciate "abnormal".&nbsp; Here is a nice example of a normal 12-Lead for you. It was obtained by a portable machine, like those used by EMS or on crash carts, so it does not include a fourth channel rhythm strip.&nbsp; Challenge your students to find the "normal" characteristics of this ECG: normal sinus rhythm; Lead II has the tallest QRS of the limb leads, indicating a normal axis; Lead V1 is primarily negative and the chest leads progress in an orderly fashion to a positive QRS in V6; no ST segment elevation or depression; no T wave inversions; no pathological Q waves; no abnormally tall or wide QRS complexes; and all intervals are normal.&nbsp; Challenge your students to pick out the normal features of this ECG.</p> <p>&nbsp;</p> <p>&nbsp;</p> </div></div></div><div class="field field-name-field-rate-this-content field-type-fivestar field-label-above"><div class="field-label">Rate this content:&nbsp;</div><div class="field-items"><div class="field-item even"><form class="fivestar-widget" action="/taxonomy/term/47/feed" method="post" id="fivestar-custom-widget--3" accept-charset="UTF-8"><div><div class="clearfix fivestar-average-text fivestar-average-stars fivestar-form-item fivestar-hearts"><div class="form-item form-type-fivestar form-item-vote"> <div class="form-item form-type-select form-item-vote"> <select id="edit-vote--6" name="vote" class="form-select"><option value="-">Select rating</option><option value="20">Give Normal 12-Lead ECG 1/5</option><option value="40">Give Normal 12-Lead ECG 2/5</option><option value="60">Give Normal 12-Lead ECG 3/5</option><option value="80">Give Normal 12-Lead ECG 4/5</option><option value="100">Give Normal 12-Lead ECG 5/5</option></select> <div class="description"><div class="fivestar-summary fivestar-summary-average-count"><span class="empty">No votes yet</span></div></div> </div> </div> </div><input class="fivestar-submit form-submit" type="submit" id="edit-fivestar-submit--3" name="op" value="Rate" /><input type="hidden" name="form_build_id" value="form-YwLkoprKlrvQZPrNI0qQLdRMlN-JLET-widsrgKnEOE" /> <input type="hidden" name="form_id" value="fivestar_custom_widget" /> </div></form></div></div></div><div class="field field-name-field-taxonomy field-type-taxonomy-term-reference field-label-above"><div class="field-label">Related Terms:&nbsp;</div><div class="field-items"><div class="field-item even"><a href="/ecg/normal" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal</a></div><div class="field-item odd"><a href="/ecg/normal-12-lead" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal 12-Lead</a></div><div class="field-item even"><a href="/ecg/normal-sinus-rhythm" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal sinus rhythm</a></div><div class="field-item odd"><a href="/ecg/normal-ecg-1" typeof="skos:Concept" property="rdfs:label skos:prefLabel" datatype="">Normal ECG</a></div></div></div><ul class="links inline"><li class="addtoany first last"><span><span class="a2a_kit a2a_target addtoany_list" id="da2a_3"> <a class="a2a_dd addtoany_share_save" href="https://www.addtoany.com/share#url=https%3A%2F%2Fwww.ecgguru.com%2Fecg%2Fnormal-12-lead-ecg-0&amp;title=Normal%2012-Lead%20ECG"><img src="/sites/all/modules/addtoany/images/share_save_256_24.png" width="256" height="24" alt="Share"/></a> </span> </span></li> </ul> Mon, 11 Jun 2012 07:11:25 +0000 Dawn 224 at https://www.ecgguru.com https://www.ecgguru.com/ecg/normal-12-lead-ecg-0#comments