Tell me basic to clinics about ECG and interpretation.
| Section | Key Takeaway |
|---|---|
| Conduction system | SA node → AV node → His bundle → Bundle branches → Purkinje fibers. Each step maps to a waveform. |
| ECG paper | Small box = 0.04 s / 0.1 mV; large box = 0.20 s / 0.5 mV |
| Waveforms | P = atrial depolarization; QRS = ventricular depolarization; T = ventricular repolarization; U = afterpotentials |
| Normal intervals | PR 120-200 ms; QRS < 120 ms; QTc < 440/460 ms |
| Axis | Normal -30° to +90/100°. Use Lead I + aVF as the quick screen. |
| 14-step approach | Harrison's gold-standard systematic method - never skip steps to avoid errors of omission |
| LVH/RVH | Voltage criteria + repolarization "strain" patterns |
| Bundle blocks | RBBB = RSR' in V1; LBBB = broad R in laterals, masks ischemia |
| AV blocks | 1st (long PR) → Wenckebach (PR lengthening) → Mobitz II (sudden drop) → 3rd (complete dissociation) |
| Ischemia/MI | STEMI = ST elevation in culprit territory + reciprocal depression; localize by lead group |
| Arrhythmias | AF (irregular, no P), flutter (sawtooth), VT (wide complex, AV dissociation), WPW (delta wave) |
| Electrolytes/drugs | Hyperkalemia (peaked T → wide QRS), hypokalemia (U waves), digitalis (scooped ST), Brugada pattern |