2. A 26yrs old lady who has complained of palpitations in past, is admitted
in ER with palpitations. HER ECG shows:
• Narrow complex tachycardia
• Rate about 200/min
• NO P waves
• Normal axis
• Regular QRS complexes
• Normal ST segments & T waves
Diagnosis:
Supraventricular tachycardia (SVT)
Narrow QRS complex
Rate about 200/min
No P waves
No P waves
3. A 55yr old man presented with h/o chest pain at rest for 6 Hrs. There are
no abnormal physical findings. His ECG tracing shows:
• Sinus rhythm
• Normal axis
• Normal QRS complexes
• ST segment depressions, Horizontal in V3-V4
• ST segment depressions, Downward sloping in lead 1, aVL, V5-V6
Diagnosis:
Anterolateral Ischemia(unstable angina)
ST segment depression, Horizontal
ST segment depression,
downward sloping
4. These 3 rhythm strips (all lead II) came from the ECGs of three different
patients. They were all in their eighties & C/O breathlessness. What
diagnosis would you consider?
A. No P waves
Irregular baselines
QRS complexes are broad, regular & slow
Diagnosis:
Atrial fibrillation with complete block
B. Constant PR interval
2:1 conduction defect
Diagnosis:
Sinus rhythm with 2nd
degree block
C. No correlation between P waves &
QRS complexes
Diagnosis:
Complete (3rd
degree)
heart block
a. No P waves Broad, regular, slow QRS
b.
Constant PR interval 2:1 conduction defect
No correlation b/w P waves & QRS complex
c.
5. This ECG was recorded from a 60 yrs old man being treated as an out patient for
severe CCF. What might be diagnosis of underlying heart conduction?
• Atrial fibrillation
• Ventricular rate of 75-200/min
• Normal axis
• Normal QRS complexes
• Downward sloping ST segment depression
esp, V5-V6
Diagnosis:
AF with uncontrolled Ventricular rate &
digoxin effect (ST segmrnt depressions)
No P waves. Irregular HR.
(AF)
ST depression
6. A 15yr old boy was referred to the outpatient for heart murmur. He had
no symptoms. What does this ECG shows?
• Sinus rhythm
• Normal axis
• Broad QRS complexes
• RSR pattern in lead I
• Wide & slurred S waves in V5
• Normal ST segments & T waves
Diagnosis:
Right bundle branch block (RBBB)
Broad QRS complex
RSR pattern
Wide & slurred S waves
7. This ECG was recorded from a 25yr old pregnant women. She
complaints of an irregular heart beat. Auscultation revealed a soft systolic
murmur but her heart was otherwise normal
• Sinus rhythm
• Normal axis
• Normal QRS complexes & T waves
• Ventricular extra systoles
Diagnosis:
Sinus rhythm with ventricular extra systoles
Ventricular Extra systole
8. A 50yr old man is seen in A & E department with severe central chest
pain which has been present for 18hrs. What does this ECG shows?
• Sinus rhythm
• Normal axis
• Q waves in V2-V4
• Raised ST segments in V2-V4
• Inverted T waves in lead I ,aVL , V2-V6
Diagnosis:
Acute anterior Myocardial infarction
ST elevation
Inverted T waves Inverted T waves
Q waves
9. This ECG was recorded from 60yr old women with rheumatic heart
disease. She had been in heart failure but this had been treated & she was
no longer breathless. What does this ECG shows?
• AF with ventricular rate of 60-65/min
• Normal axis
• Normal QRS complexes
• Prominent U waves in V2 (Suggest Hypokalemia)
• Downward sloping ST segments in V5-V6 (Suggest Digoxin effect)
U waves Downward sloping
ST segments
No P waves (AF)
Diagnosis:
AF with Digoxin effect
10. This ECG was recorded from 65yrs old women admitted in A&E
department with sever chest pain for 1 hr. What does this ECG shows?
• Sinus rhythm
• Normal axis
• Probably normal QRS complexes
• Grossly ST segment elevation in anterior & lateral leads
• Depressed ST segments in inferior leads, lead III, aVF
ST elevation
ST elevation
Depressed ST segments
Depressed ST segments
Diagnosis:
Acute anterolateral MI
11. This ECG was recorded from 60yr old man seen in clinic because of
severe breathlessness which had developed over several years. His JVP is
raised. What does his ECG shows?
• Sinus rhythm, rate 140/min
• One ventricular Extra systole
• Peaked P waves (best in lead II, III, aVF)
• Normal PR interval
• Right axis
• Dominant R waves in V1
• Deep S waves In V6
• Normal ST segments & T waves
Extra systole
Peaked P waves
Right axis Dominant R waves
Deep S waves
Diagnosis:
Sinus tachycardia with 1
ventricular extra systole, Right atrial
& right ventricular hypertrophy &
clockwise rotation suggests COPD
13. • What is the PR interval in this ECG?
• A. 0.12 se
B. 0.16 sec C. 0.20 sec D. 0.28 sec E. 0.50 sec
Q. 01
14. Q. 02
What is the QRS duration seen here?
A. 0.04 sec B. 0.06 sec C. 0.10 sec D. 0.12 sec E. 0.14
15. Q. 3
What is the approximate heart rate?
A. 50 bpm B. 65 bpm C. 75 bpm D. 90 bpm E. 100 bpm
16. Q. 04
What type of arrhythmia is
pointed out by the two
arrows?
A. PACs (Premature Atrial
Complexes)
B. PVCs (Premature
Ventricular Complexes)
C. 1 is a PAC, and 2 is a
PVC
D. PSVT (Paroxysmal
Supraventricular Tachycardia)
E. Left Bundle Branch Block
17. Q. 05
Choose from the following
responses to interpret this
ECG.
A. PJC (Premature
junctional complex)
B. Atrial flutter
C. Atrial fibrillation
D. AV nodal reentrant
tachycardia
E. Accelerated junctional
rhythm
