Show me the 10 most common heart disease with ecg pattern

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ECG patterns common heart diseases electrocardiogram

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ST elevation myocardial infarction STEMI ECG leads

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atrial fibrillation ECG irregular rhythm no P waves

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heart block complete AV block third degree ECG bradycardia

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left ventricular hypertrophy ECG voltage criteria Sokolow

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ventricular tachycardia wide QRS tachycardia ECG

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pericarditis saddle-shaped ST elevation diffuse ECG

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hypertrophic cardiomyopathy ECG deep Q waves LVH

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pulmonary embolism ECG S1Q3T3 right heart strain sinus tachycardia

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Wolff-Parkinson-White WPW delta wave short PR ECG pre-excitation

I now have excellent ECG images for all 10 conditions. Here is a comprehensive guide:

10 Common Heart Diseases & Their ECG Patterns

1. 🫀 ST-Elevation Myocardial Infarction (STEMI)

ECG Pattern:

ST elevation ≥1 mm in ≥2 contiguous limb leads, or ≥2 mm in ≥2 contiguous precordial leads
Hyperacute T waves (tall, peaked) in early phase
Pathological Q waves (>40 ms wide, >25% of R-wave height) in evolved MI
Reciprocal ST depression in opposing leads
"Tombstone" morphology in severe proximal LAD occlusion

Territory	Leads with ST Elevation	Artery
Anterior	V1–V4	LAD
Inferior	II, III, aVF	RCA
Lateral	I, aVL, V5–V6	LCx
Posterior	ST depression V1–V2 + tall R	RCA/LCx

Anterior STEMI with tombstone morphology

2. 🫀 Atrial Fibrillation (AF)

ECG Pattern:

Irregularly irregular R-R intervals — the hallmark
Absent P waves replaced by fine/coarse fibrillatory (f) waves (best seen in V1)
Narrow QRS complexes (unless aberrant conduction or bundle branch block)
Rapid ventricular response if uncontrolled (>100 bpm)

Atrial fibrillation — irregularly irregular rhythm, absent P waves

3. 🫀 Complete (3rd-Degree) AV Heart Block

ECG Pattern:

AV dissociation — P waves and QRS complexes fire completely independently
Atrial rate faster than ventricular rate
Regular, slow ventricular escape rhythm (~20–40 bpm)
Narrow QRS = nodal escape; Wide QRS = ventricular/infranodal escape
No fixed PR interval

Complete 3rd-degree AV block — P waves and QRS dissociated

4. 🫀 Left Ventricular Hypertrophy (LVH) — Hypertensive Heart Disease

ECG Pattern:

Sokolow-Lyon criteria: S in V1 + R in V5 or V6 ≥35 mm
Cornell criteria: R in aVL + S in V3 >28 mm (men), >20 mm (women)
LV strain pattern: ST depression + T-wave inversion in I, aVL, V5–V6
Left axis deviation
Broadened QRS (not always frank LBBB)

LVH with strain pattern — deep T inversions in lateral leads

5. 🫀 Ventricular Tachycardia (VT)

ECG Pattern:

Wide QRS tachycardia (QRS >120 ms) at rate ≥100 bpm
Regular or slightly irregular rhythm
AV dissociation (P waves independent of QRS)
Fusion beats and capture beats (pathognomonic)
Concordance in precordial leads (all positive or all negative)
Northwest/superior axis deviation

Feature	Points toward VT
QRS >160 ms	✓
Positive concordance V1–V6	✓
AV dissociation	✓ (pathognomonic)
Brugada/Wellens criteria	✓

Monomorphic VT — wide complex tachycardia with positive concordance

6. 🫀 Acute Pericarditis

ECG Pattern (4 evolutionary stages):

Stage 1: Diffuse saddle-shaped (concave) ST elevation in almost all leads; PR depression; ST elevation in aVR absent or with PR elevation
Stage 2: ST normalizes, T waves flatten
Stage 3: Diffuse T-wave inversions
Stage 4: Normalization
Key differentiator from STEMI: Diffuse (not localised), no reciprocal changes except aVR, PR segment depression

Acute pericarditis — diffuse saddle-shaped ST elevation + PR depression

7. 🫀 Pulmonary Embolism (PE)

ECG Pattern:

Most common: Sinus tachycardia (non-specific)
Classic S₁Q₃T₃ pattern: Deep S in I, Q wave in III, inverted T in III
Right bundle branch block (complete or incomplete)
T-wave inversions in V1–V4 (right ventricular strain)
Right axis deviation
P pulmonale (peaked P waves in II ≥2.5 mm)
New AF in massive PE

Pulmonary embolism — S1Q3T3 pattern + RV strain

8. 🫀 Hypertrophic Cardiomyopathy (HCM)

ECG Pattern:

LVH voltage criteria (tall R in lateral leads, deep S in right leads)
Deep narrow Q waves in lateral (I, aVL, V5–V6) and inferior leads — due to septal hypertrophy
Apical HCM (Yamaguchi): Giant deep symmetric T-wave inversions in V3–V5 (≥10 mm depth)
ST depression in lateral leads
Left axis deviation
AF occurs in 20–25% of patients

Apical HCM — giant symmetric T-wave inversions in precordial leads

9. 🫀 Wolff-Parkinson-White (WPW) Syndrome

ECG Pattern (Classic Triad):

Short PR interval (<120 ms)
Delta wave — slurred initial upstroke of QRS
Widened QRS (>120 ms) due to pre-excitation

Secondary ST-T changes discordant with delta wave direction
Risk: can precipitate AF → rapid conduction via accessory pathway → VF

Pathway Location	Delta Polarity
Left lateral	Negative in V1, positive in I
Posteroseptal	Negative in II, III, aVF
Anteroseptal	Positive in V1

10. 🫀 Dilated Cardiomyopathy (DCM)

ECG Pattern:

Left bundle branch block (LBBB) — most characteristic
- QRS ≥120 ms, broad notched R in I/aVL/V5–V6, deep S/QS in V1–V3
Diffuse ST-T changes (secondary to LBBB or ischaemia)
Left axis deviation
AF is common (30–40%)
Low voltage QRS (if severe fibrosis or pericardial effusion co-exists)
P mitrale (broad bifid P waves in II) — left atrial enlargement
Pseudo-infarction Q waves mimicking prior MI

LBBB pattern — broad notched R waves laterally, deep QS in V1–V3

Quick Reference Summary

#	Condition	Key ECG Finding
1	STEMI	ST elevation, Q waves, reciprocal depression
2	Atrial Fibrillation	Irregularly irregular, no P waves
3	Complete Heart Block	AV dissociation, slow escape rhythm
4	LVH / HTN Heart Disease	High voltage + strain pattern
5	Ventricular Tachycardia	Wide QRS ≥120 ms, AV dissociation
6	Acute Pericarditis	Diffuse saddle ST elevation, PR depression
7	Pulmonary Embolism	Sinus tachycardia, S₁Q₃T₃, RV strain
8	Hypertrophic Cardiomyopathy	Giant T inversions, deep Q waves
9	WPW Syndrome	Short PR, delta wave, widened QRS
10	Dilated Cardiomyopathy	LBBB, AF, low voltage

Sources: Braunwald's Heart Disease (Elsevier), ROSEN's Emergency Medicine; ECG images from peer-reviewed clinical literature via PMC.

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Heart Diseases ECG Guide

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What's inside the PDF:

Cover page with title and condition list on a deep red background
10 individual sections, each with:
- Numbered header bar (red)
- Bullet-point key ECG findings
- Localisation/criteria table (where applicable — STEMI, VT, WPW)
- Full-width real 12-lead ECG image from peer-reviewed clinical literature
- Annotated caption describing the ECG
Quick Reference Summary table at the end listing all 10 conditions and their hallmark ECG finding
Running header and page footer with source attribution on every page

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