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Electrocardiogram (ECG) Interpretation

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Left Atrial Enlargement (LAE)

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Indicated by a broad, notched P wave in lead II and a biphasic P wave in V1; suggests increased left atrial pressure or volume.

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Right Ventricular Hypertrophy (RVH)

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Suggests thickening of the right ventricle; characterized by a tall R wave in V1 and a deep S wave in V6.

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Right Atrial Enlargement (RAE)

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Evidenced by tall, peaked P waves in lead II and a biphasic P wave with a prominent initial component in V1; may indicate pulmonary disease or tricuspid valve disease.

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Electrical Alternans

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Regular beat-to-beat variations in the amplitude of QRS complexes; often associated with pericardial effusion.

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QT Interval

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Reflects the total time for ventricular depolarization and repolarization; prolonged QT can lead to torsades de pointes.

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U wave

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Wave following the T wave; its presence can be associated with hypokalemia or bradycardia.

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Premature Atrial Contraction (PAC)

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A heartbeat that occurs earlier than expected and originates from the atria; can be benign or indicate underlying pathology.

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PR Interval

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Time from the onset of the P wave to the start of the QRS complex; prolonged PR interval may indicate first-degree heart block.

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Sinus Rhythm

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Normal rhythm of the heart; each P wave is followed by a QRS complex and is originated from the sinoatrial node.

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Atrial Flutter

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Rapid heart rate due to an atrial reentrant circuit; characterized by a 'sawtooth' pattern in the P waves, typically in the inferior leads.

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Second-Degree AV Block Type II (Mobitz II)

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Some P waves do not lead to a QRS complex despite a constant PR interval; may progress to a third-degree block.

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Pericarditis

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Inflammation of the pericardium; ECG shows diffuse ST segment elevation without reciprocal changes and PR segment depression.

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QRS Complex

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Represents ventricular depolarization; widened QRS may signify bundle branch block or ventricular hypertrophy.

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Ventricular Tachycardia (VTach)

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A rapid, regular heartbeat that arises from improper electrical activity in ventricular tissue; may lead to ventricular fibrillation.

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Bundle Branch Block

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Delay or block in the conduction pathway of the right or left bundle branches; results in wide QRS complexes (>120 milliseconds).

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First-Degree AV Block

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Slowed conduction without missed beats; the PR interval is prolonged (>200 milliseconds).

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Second-Degree AV Block Type I (Wenckebach)

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Progressively lengthening PR interval until a beat is dropped; not every P wave is followed by a QRS.

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Hyperkalemia

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High potassium levels that can cause peaked T waves, widened QRS complexes, and in severe cases, can lead to cardiac arrest.

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T wave

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Indicates ventricular repolarization; abnormal T waves can signify ischemia, hyperkalemia, or left ventricular hypertrophy.

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Premature Ventricular Contraction (PVC)

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A heartbeat that occurs earlier than expected and originates from the ventricles; frequent PVCs may require further evaluation.

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Hypokalemia

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Low potassium levels that may lead to flat T waves, prominent U waves, and potentially arrhythmias.

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ST Segment

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Segment between the QRS complex and T wave; elevation or depression may indicate myocardial infarction or ischemia.

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Isoelectric line

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The baseline of the ECG; deviations may indicate electrical injury or artifact.

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Sinus Bradycardia

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A slower-than-normal heart rate; can indicate high vagal tone, inherent sinus node dysfunction, or be normal in athletes.

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Ventricular Fibrillation (VFib)

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Disorganized electrical signals that cause inefficient heart contractions; can lead to sudden cardiac death.

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Atrial Fibrillation (AFib)

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Irregular, often rapid heart rate causing poor blood flow; characterized by absence of P waves and irregularly irregular rhythm.

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Third-Degree AV Block (Complete Heart Block)

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No atrial impulses pass to the ventricles, leading to independent atrial and ventricular rhythms; typically requires a pacemaker.

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Left Ventricular Hypertrophy (LVH)

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Suggests thickening of the left ventricle; often demonstrates a high R wave in lateral leads and a deep S wave in the right precordial leads.

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P wave

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Represents atrial depolarization; can indicate atrial enlargement if abnormal.

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Sinus Tachycardia

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A faster-than-normal heart rate; may result from fever, anxiety, hypovolemia, or heart failure.

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Acute Myocardial Infarction (AMI)

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Occurs when blood flow to part of the heart is blocked for a long enough time to cause heart muscle damage; ST elevation and pathological Q waves are key ECG findings.

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