II. Criteria: EKG Validity

  1. Limb Lead I is mirror of aVR
  2. R Wave Progression across precordial leads
    1. R Wave more prominent by lead V4
    2. Poor progression in anterior Myocardial Infarction
  3. Voltage standardization mark at 1 mv
    1. Two big boxes tall (10 mm)
    2. Five small boxes wide (25 mm/sec)

III. Criteria: Dextrocardia

  1. Lead I Inverted
  2. Lead II and Lead III switched
  3. Lead aVR and aVL switched
  4. Precordium (V1 to V6) with Dominant S Wave and Poor R Progression

IV. Criteria: Lead Reversals

  1. Left Arm - Right Arm Reversal (LA-RA Reversal)
    1. Nearly identical to Dextrocardia EXCEPT Precordium is unaffected in LA-RA reversal
    2. Lead I Inverted (affecting all complexes: P-QRS-T)
    3. Lead II and Lead III switched
    4. Lead aVR and aVL switched
  2. Left Leg - Right Leg Reversal (LL-RL Reversal)
    1. Right leg (RL) is a grounding lead and its reversal with left leg (LL) results in no EKG changes
  3. Left Arm - Left Leg Reversal (LA-LL Reversal)
    1. Lead III inverted (affecting all complexes: P-QRS-T)
    2. Lead I and Lead II switched
    3. Lead aVF and aVL switched
  4. Left Arm - Right Leg Reversal (LA-RL Reversal)
    1. Lead I appears similar to Lead II
    2. Lead III flatline (pseudo-Asystole with difficult to discern P, QRS and T complexes)
    3. aVR similar to inverted Lead II
    4. aVF and aVL appear similar
  5. Right Arm - Left Leg Reversal (RA-LL Reversal)
    1. Lead II inverted (affecting all complexes: P-QRS-T)
    2. Lead I and Lead III are switched and inverted versions of one another
    3. Lead aVF and aVR switched
  6. Right Arm - Right Leg Reversal (RA-RL Reversal)
    1. Lead I appears similar to inverted Lead III
    2. Lead II flatline (pseudo-Asystole with difficult to discern P, QRS and T complexes)
    3. aVL appears similar to inverted Lead III
    4. aVR and aVF appear similar to one another
  7. Left Arm - Left Leg AND Right Arm - Right Leg Reversal (LA-LL + RA-RL Reversal)
    1. Lead I flatline (pseudo-Asystole with difficult to discern P, QRS and T complexes)
    2. Lead II appears similar to inverted Lead III
    3. Lead III inverted (affecting all complexes: P-QRS-T)
    4. aVR and aVL appear similar to one another
    5. avF appears similar to inverted Lead III

V. References

  1. Berberian (2023) Crit Dec Emerg Med 37(6): 12-3

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Ontology: Electrocardiography (C1623258)

Definition (NCI_NCI-GLOSS) A line graph that shows changes in the electrical activity of the heart over time. It is made by an instrument called an electrocardiograph. The graph can show that there are abnormal conditions, such as blocked arteries, changes in electrolytes (particles with electrical charges), and changes in the way electrical currents pass through the heart tissue.
Definition (NCI) A procedure that displays the electrical activity of the heart.
Definition (CSP) measurement and interpretation of electrical manifestations of heart activity.
Definition (MSH) Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
Concepts Diagnostic Procedure (T060)
MSH D004562
ICD9 89.52
SnomedCT 164960001, 164844004, 146485007, 142135006, 142007005, 271334005, 46825001, 29303009
LNC LP6244-0, LP100599-2, LP57609-7
English ECG, EKG, electrocardiography, Electrocardiography NOS, Electrocardiography NOS (regime/therapy), ELECTROCARDIOGR, electrocardiogram (procedure), electrocardiogram, Electrocardiograph, Electrocardiography (procedure), Electrocardiography NOS (procedure), Electrocardiographs, Electrocardiogram, Electrocardiographic procedure (procedure), Electrocardiographic procedure, Electrocardiographic procedure, NOS, Electrocardiogram, NOS, EKG (Electrophysiology), ECG NOS, Electrocardiography
Italian Elettrocardiogramma, ECG, EKG, Elettrocardiografia
French ECG, EKG, ECG (ÉlectroCardioGraphie), Electrocardiogramme, Électrocardiographie
Swedish Elektrokardiografi
Spanish electrocardiografía, SAI (régimen/tratamiento), electrocardiografía, SAI (procedimiento), Electrocardiography NOS, electrocardiografía, SAI, ECG, electrocardiograma, procedimiento electrocardiográfico (procedimiento), procedimiento electrocardiográfico, Electrocardiograma, EKG, Electrocardiografía
Japanese シンデンズ, 心電図記録法, 心電図検査, 心電図検査法, 心電図記録, 心電計, 心電図
Czech elektrokardiografie, Elektrokardiogram, EKG
Finnish Elektrokardiografia
Russian ELEKTROKARDIOGRAFIIA, EKG, EKG PATTERN, ЭКГ ПАТТЕРН, ЭКГ ИЗОБРАЖЕНИЕ, EKG IZOBRAZHENIE, ЭКГ, ЭЛЕКТРОКАРДИОГРАФИЯ
Croatian ELEKTROKARDIOGRAFIJA
Polish Wykres EKG, Badanie elektrokardiograficzne, EKG, Elektrokardiografia, Zapis EKG
Hungarian EKG, Elektrokardiogram
Norwegian ECG, Elektrokardiografi, Elektrocardiografi, EKG
Portuguese Electrocardiograma, ECG, EKG, Eletrocardiografia
Dutch elektrocardiogram, ECG, Elektrocardiografie
German Elektrokardiogramm, ECG, EKG, Elektrokardiographie