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What does this ECG Say?


I'm testing my ECG skills and would like to know what the following means. I think that it is abnormal and pathologic. Is it abnormal and if it is, is it evidence of a cardiac arrest?




If the pictures do not show up, you can view it at the following sites.

https://docs.google.com/open?id=0BxhO58ifPHXAV3lfdjhEZDlzVXc (A)



Does it matter if the above appear in Lead I or II?

Here's a picture from Lead II, is this a flat line? It happened prior to an ST elevation occurring and T-Wave(I think this is what it's called) peaks that looked very high. See A.

Thank You. I don't have any skills in reading ECGs so please help me interpret this.


Specializes in GICU, PICU, CSICU, SICU. Has 6 years experience.

The quality of the images in the link is very poor.

The first link looks like a pacemaker kicking in.

The second link could be anything.

The third link looks pretty normal.

Other than that I can't provide you with much insight without better quality pictures. These look like they are taken from internet resources, didn't they state what the rhythms were?

Esme12, ASN, BSN, RN

Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma. Has 40 years experience.

The first one it looks like V2 and V5....there might be some slight ST changes but not clinically significant the underlying rhythm appears sinus. I see a P wave before every QRS (all 3 of them)

The second is V4 but I am clueless to the rhythm.....these are horrible.

This is Lead 1 and AVR. The rhythm is Sinus The PR is .18 and the QRS .O8

Wow those are some Baaad strips. :bugeyes:

turnforthenurse, MSN, NP

Specializes in ER, progressive care. Has 7 years experience.

I agree. Bad strips! :uhoh3:

1st: I see sinus rhythm, maybe some ST elevation.

2nd: Lead V4...I think I see QRS complexes but low-voltage? The blue circle looks like it could be hiding a QRS complex.

3rd: looks normal. aVR has negative deflections which is what it should be.


Specializes in ED. Has 1 years experience.

you cannot evaluate these strips unless you look at the whole 12 lead ekg (looking for an mi? you need "elevated" st in 3 leads). taking 1 or 2 leads out doesn't give you a picture of what is going on.

does it matter lead i or lead ii? lead i gives you a different view of the heart then lead ii, so in some ways yes it matters. leadi looks from you left arm to your right arm. leadii looks from your left leg to right arm.

peaked t waves: maybe k+ imbalance. are thoses peaked t waves? not really.

my questions is where did the strips come from? is this part of a class?

if you are just looking for

rhythms than i just see sinus eg p wave with qrs but i would need longer strips to make out anything more.


Specializes in .. Has 16 years experience.

You cannot evaluate these strips unless you look at the whole 12 lead EKG (Looking for an MI? You need "elevated" ST in 3 leads). Taking 1 or 2 leads out doesn't give you a picture of what is going on.

This is not correct. The diagnostic criteria for a STEMI is 1mm or more of ST-elevation in TWO or more contiguous leads. Where did you learn ST elevation needs to be present in 3 leads?

I can't tell you anything regarding the strips due to the low quality of the images. But as far as your question asking if the patient could be in cardiac arrest with those rhythms, the answer is yes. That would be called PEA or pulseless electrical activity. You can have a sinus rhythm on the monitor and have a patient in cardiac arrest.