Interpretetion of Common ECGs and Case-Based Discussion #257013

Upon completion of this course, participants will be able to:

• Apply a Systematic Approach: Utilize a standardized, step-by-step method for interpreting any ECG.

• Accurately Identify Common Arrhythmias: Recognize and diagnose supraventricular tachycardias (SVTs), atrial fibrillation/flutter, ventricular tachycardias, and heart blocks.

• Recognize ECG Signs of Ischemia and Infarction: Identify ST-elevation myocardial infarction (STEMI) and non-ST-elevation ACS patterns, including localizing the infarct territory.

• Interpret Chamber Enlargement and Bundle Branch Blocks: Recognize patterns suggesting atrial enlargement, ventricular hypertrophy, and conduction delays.

• Identify Critical “Can’t-Miss” ECG Findings: Recognize life-threatening patterns such as hyperkalemia, pericardial effusion/tamponade (electrical alternans), and prolonged QT interval.

• Synthesize ECG Findings with Clinical Presentation: Integrate ECG interpretation into the broader clinical context to guide patient management decisions.

This course is essential for any healthcare professional involved in the acquisition, interpretation, or clinical application of ECGs.

• Medical Students and Residents (Internal Medicine, Family Medicine, Emergency Medicine)

• Registered Nurses, Nurse Practitioners, and Physician Assistants (especially in ED, ICU, CCU, telemetry units)

• Paramedics and Emergency Medical Technicians (EMTs)

• Primary Care Physicians

• Cardiology Fellows seeking a structured review

• Other Allied Health Professionals responsible for cardiac monitoring

• Pre-assessment
• Live group instruction
• Use of real-world examples, case studies and exercises
• Interactive participation and discussion
• Power point presentation, LCD and flip chart
• Group activities and tests
• Each participant receives a binder containing a copy of the presentation
• slides and handouts
• Post-assessment

Day 1: The Foundation – System, Waves, and Intervals

• Morning:

  • Module 1: Fundamentals of Electrocardiography: Electrical conduction of the heart, lead placement, and what each lead represents.

  • Module 2: The Systematic Approach: Introducing an 8-step method (Rate, Rhythm, Axis, Intervals, P-wave, QRS, ST-segment, T-wave).

• Afternoon:

  • Module 3: Mastering Intervals (PR, QRS, QT): Measurement, normal values, and clinical significance of prolonged/shortened intervals.

  • Case-Based Session 1: Practice Makes Perfect. Hands-on practice measuring intervals and applying the systematic approach to normal ECGs.

  • Day 1 Recap: Mastering the language and the method.

Day 2: The Rhythm Strip – Conduction Abnormalities

• Morning:

  • Module 4: Sinus Rhythms and Atrial Arrhythmias: Identifying sinus node dysfunction, premature atrial complexes (PACs), atrial tachycardia, atrial flutter, and atrial fibrillation.

  • Module 5: AV Blocks: Recognizing and differentiating 1st, 2nd (Mobitz I & II), and 3rd-degree heart block.

• Afternoon:

  • Module 6: Ventricular Arrhythmias: Identifying premature ventricular complexes (PVCs), ventricular tachycardia, ventricular fibrillation, and idioventricular rhythms.

  • Case-Based Session 2: The Rhythm Challenge. A rapid-fire session focused solely on interpreting rhythm strips for a wide variety of arrhythmias.

  • Day 2 Recap: You are the conductor. Diagnosing the heart’s electrical rhythm.

Day 3: Chamber Enlargement, Bundle Branches, and Axis

• Morning:

  • Module 7: Axis Determination: Quick methods for calculating the QRS axis and understanding the clinical implications of axis deviation.

  • Module 8: Chamber Enlargement: Criteria for left and right atrial abnormality and left and right ventricular hypertrophy.

• Afternoon:

  • Module 9: Bundle Branch Blocks: Diagnosing complete and incomplete Right Bundle Branch Block (RBBB) and Left Bundle Branch Block (LBBB).

  • Case-Based Session 3: The Structural Puzzle. Cases focused on identifying hypertrophy, enlargement, and conduction delays, and understanding how they affect the ECG overall.

  • Day 3 Recap: Reading the heart’s anatomy from its electricity.

Day 4: Ischemia, Infarction, and “Can’t-Miss” ECGs

• Morning:

  • Module 10: Ischemia, Injury, and Infarction: The pathophysiology and ECG evolution of STEMI. Identifying ST-elevation, depression, T-wave inversion, and Q-waves.

  • Module 11: Localizing the Infarct: Correlating ECG changes (e.g., inferior, anterior, lateral MI) with the occluded coronary artery.

• Afternoon:

  • Module 12: “Can’t-Miss” ECGs: Recognizing patterns of hyperkalemia (peaked T-waves, widened QRS), hypokalemia, pericarditis, pulmonary embolism (S1Q3T3), and Wolff-Parkinson-White (WPW).

  • Case-Based Session 4: The Code Blue. High-acuity cases focusing on identifying STEMI and other critical, life-threatening ECG findings that require immediate action.

  • Day 4 Recap: From diagnosis to action – the ECGs that change management instantly.

Day 5: Integration and Mastery – The Comprehensive Case

• Morning:

  • Module 13: Pitfalls and Artifacts: Common mimics of pathology (e.g., lead misplacement, tremor) and how to avoid misinterpretation.

  • Module 14: Putting It All Together: How to write a clear, concise, and clinically useful ECG impression.

• Afternoon:

  • Capstone Activity: The Grand Round. Participants work through a series of complex, multi-faceted ECGs that incorporate all elements learned during the week (rhythm, ischemia, blocks, etc.).

  • Final Interpretation Challenge & Review: A final test of skills with immediate feedback and discussion.

  • Course Conclusion: Q&A, key takeaways, and awarding of certificates.