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National IM Clerkship Objectives for ECG Interpretation

Approach ECG interpretation in a systematic and logical fashion analyzing

the following: rate, rhythm, P wave morphology, PR interval, QRS width,

axis, voltage, QT interval, ST segment morphology, and T wave morphology.

Recognizing the following on ECG:

• Sinus tachycardia, sinus bradycardia, sinus arrhythmia.

• Premature atrial beats, ectopic atrial rhythm/tachycardia, narrow

complex supraventricular tachycardia.

• Multifocal atrial tachycardia, atrial flutter, atrial fibrillation

• First degree, second degree (Mobitz type I and II), and third degree

(complete) heart block.

• Junctional rhythm.

• Premature ventricular beats.

• Typical ventricular tachycardia, ventricular fibrillation.

• Left and right atrial enlargement.

• Left ventricular hypertrophy.

• Left and right bundle branch block, left anterior and posterior

fascicular block.

• The characteristic features of a properly functioning ventricular or dual

chamber pacemaker.

• The delta wave in Wolf-Parkinson-White Syndrome.

• The classic features of myocardial ischemia and infarction and be able

to localize the findings (i.e. inferior, anterior, lateral, posterior, right

ventricular) and identify the probable culprit vessel.

• The classic features of pulmonary embolism.

• The characteristic effects of hypo- and hyperkalemia.

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