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Abnormal Q waves — 31 percent sensitivity; Cabrera's sign — 27 percent sensitivity, 47 percent for anteroseptal MI; Initial positivity in V1 with a Q wave in V6 — 20 percent sensitivity but 100 percent specificity for anteroseptal MI
In lead V 1, the QRS complex is often entirely negative (QS morphology), although a small initial R wave may be seen (rS morphology). In the lateral leads (I, aVL, V 5-V 6) the QRS complexes are usually predominantly positive with a slow upstroke last >60ms to the R-wave peak. [4] Notching may be seen in these leads but this is not universal.
Hyperacute T waves need to be distinguished from the peaked T waves associated with hyperkalemia. [16] In the first few hours the ST segments usually begin to rise. [17] Pathological Q waves may appear within hours or may take greater than 24 hr. [17] The T wave will generally become inverted in the first 24 hours, as the ST elevation begins to ...
Rule 9: There is no Q wave or only a small q (<0.04 seconds in width) in I, II and V2 to V6. Rule 10: The T wave is upright in I II and V2 to V6. The end of the T wave should not drop below the isoelectric baseline. Rule 11: Does the deepest S wave in V1 plus the tallest R wave in V5 or V6 equal >35 mm? Rule 12: Is there an Epsilon wave?
The ECG will show a terminal R wave in lead V1 and a slurred S wave in lead I. Left bundle branch block widens the entire QRS, and in most cases shifts the heart's electrical axis to the left. The ECG will show a QS or rS complex in lead V1 and a monophasic R wave in lead I.
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A 12-lead ECG of a woman with Ebstein's anomaly: The ECG shows signs of right atrial enlargement, best seen in V1. Other P waves are broad and tall, these are termed "Himalayan" P waves. Also, a right bundle-branch block pattern and a first-degree atrioventricular block (prolonged PR-interval) due to intra-atrial conduction delay are seen.
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