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An R wave follows as an upward deflection, and the S wave is any downward deflection after the R wave. The T wave follows the S wave, and in some cases, an additional U wave follows the T wave. To measure the QRS interval start at the end of the PR interval (or beginning of the Q wave) to the end of the S wave.
When normal, the RV is about half the size of the left ventricle (LV). When strained, it can be as large as or larger than the LV. [ 5 ] An important potential finding with echo is McConnell's sign , where only the RV apex wall contracts; [ 7 ] it is specific for right heart strain and typically indicates a large PE.
There are 6 different sinus arrhythmia. [1] [2]A normal heart should have a normal sinus rhythm, this rhythm can be identified by a ventricular rate of 60-100 bpm, at a regular rate, with a normal PR interval (0.12 to 0.20 second) and a normal QRS complex (0.12 second and less).
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. The small Q-waves that are usually seen in the lateral leads are absent in LBBB. [4]
The 2018 European Society of Cardiology/American College of Cardiology Foundation/American Heart Association/World Health Federation Universal Definition of Myocardial Infarction for the ECG diagnosis of the ST segment elevation type of acute myocardial infarction require new ST elevation at J point of at least 1mm (0.1 mV) in two contiguous leads with the cut-points: ≥1 mm in all leads ...
rS pattern (small r, deep S) in the inferior leads II, III, and aVF; Delayed intrinsicoid deflection in lead aVL (> 0.045 s) LAFB cannot be diagnosed when a prior inferior wall myocardial infarction (IMI) is evident on the ECG. IMI can also cause extreme left-axis deviation, but will manifest with Q-waves in the inferior leads II, III, and aVF.
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It is calculated as the time from the start of the Q wave to the end of the T wave, and approximates to the time taken from when the cardiac ventricles start to contract to when they finish relaxing. An abnormally long or abnormally short QT interval is associated with an increased risk of developing abnormal heart rhythms and sudden cardiac death.