Intro to EKG Interpretation - Chamber Enlargement

A video on the identification of atrial enlargement and ventricular hypertrophy on EKG. Viewing in 1080p is highly recommended (click on the gear icon just below the lower right corner of the video).

This material is made available under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

[romeolhk]

Damm you should get a Nobel Prize from this, Nobel Prize of education!

[kevlyei]

Greatly appreciate the effort put into making these videos. 30 mins video probably took many hours/days of preparation.

[StrongMed]

@ho littleho, none of the EKG tracings are upside down.  However, a prior commenter was thrown off the orientation of the heart in the diagrams showing the relationship of the heart to the precordial leads (which is what I suspect you are referring to).  That view is an axial cross section in which the front of the heart is at the top of the picture, and the heart's left side is on the right side of the screen.  This view was unexpected and a little disorienting to me the first time I saw it, but it is the standard used in cross sectional anatomy, including CT and MRI scans.  I know that some people would prefer the more intuitive view with the heart at the bottom, but for better or worse, convention puts it at the top.  Hope that helps!

[cynthiamacaringue]

hello, Dr, I would like to say that your youtube lessons have helped me alot, Im a 6th year med student and our classes on ECG were very poor since inthe hospital were I was working there was only one electrocardiogram and it belonged to the cardiologist who then left... I just wanted to ask you to increase the volume in your videos as the sound is very low and if you could provide exam exercises for us to work out?

[mohammedreehan]

Probably the Most Productive 30 Mins of My Medical Education so far, Thanks a lot Sir

[jennymatthews]

I drew the P waves from this lecture on a large piece of paper for students in my most recent 12 lead class to illustrate the concept of atrial enlargement. The student feedback was very positive and requested the p wave paper drwaings be incorporated into the ppt lecture. I think this is just further evidence that the info presented is very clear and valued by beginning 12 lead students! thank you!

[blanketmonster]

This was amazing, I finally understand EKGs for the first time ever despite EKGs being "taught" to me numerous times before. Thank you for sharing your knowledge, Dr. Strong. You are a great teacher :)

[StrongMed]

DODesertDweller, you're right that If a patient has evidence of RVH, and also has tall R waves with T wave inversion in V6, if would certainly suggest concurrent LVH. However, I don't think the RVH example shows these findings. I think u might be looking at a different lead?

[PHILOSOPHISER]

There are courses for WCG interpretation that are expensive. This is free and far more comprehensive. Thanks for your educational service

[jasonyang]

Thank you so much for these great lectures. Would you be able to post pdf slides on your google drive for all your lectures (or at least for the EKG ones)? They would greatly enhance what is an already brilliant lecture series.

Cheers,

Jason

[robertgallego]

This series is awesome especially for those re-entering into healthcare like myself.  Dr. Eric provides both book and online resources in addition to his lectures., One should feel confident with their skills after completing the course. Bravo both thorough and well done, thank you Dr. Eric

[mosalah]

15:07
Why in RVH v1 has qR since it records RV 1st
While v6 rS as it records LV 1st?

[freetime]

i wished i had known about these great lectures earlier, many thanks for you

[tomparkhill]

really so helpful! just putting the heart in the ribcage and showing the vector movements for each change makes understanding it so much easier. thanks!

[vidararason-tex]

Dr. Strong, thank you so much for all this great lessons. I have only watch´t nine of them so far, this is truly one of the best training that one can get on Youtube. This is helping a lot in my paramedic training. All the best from Iceland.

[mpatricksweeney]

Thanks for the great lecture, Dr Strong. Why in the discussion of RVH represented in the precordial leads do we see the initial positive deflection in V6? I would have expected a QS wave in V6, with no positive deflection: that is, the initial septal depolarization (physiologic Q), followed by the deeper negative deflection of RV depolarization, with the "electrically humble" left ventricular wave subsumed/concealed within the deep negative S wave. The early R wave/positive deflection in V6 suggests at some point (after septal depolarization?) that the summation vector is decidedly toward the LV, then reverses toward the hypertrophied RV. Does the normal-size LV depolarize faster than the hypertrophied RV, such that early in the QRS complex the summation wave is toward V6? Is conduction in the LBB faster than in the RBB? In conduction less efficient in a hypertrophied ventricle? Does the degree of RVH affect the precordial QRS complex, ie in a massively remodeled RV (or a newborn's), could we see the LV wave fully subsumed in the RV wave? Finally, in RVH, why have we lost the septal depolarization wave in V1 and V6, with the first deflection representing LV depolarization?

[PavanMehat]

Thank you for the amazing video!!!! I LOVE STANFORD!! 👊 This was so hard to understand but know makes sense. :)

[prakashduraisamy]

M having a doubt in RVH how come a deep S wave is formed in V6.. If the deep S wave is due to net deflection of vector towards right side then how come a positive 'r' wave is formed in V6? Its is due to?


At the same time in RVH in V1 there will be tall R wave follwed by a small s wave . This s wave is due to ?

[amirkhandurranivlogs]

Complicated make it the end of video gained nothing...just kidding excellent piece of work Dr, , , thanks for sharing valuable information with us.

[amykowald]

Really appreciated the quiz after the presentation. Hope you add that to more of your presentations.