Overview

Electrocardiogram is a non-invasive diagnostic procedure that records the electrical activity of the heart over time, providing crucial information about cardiac rhythm and function.

ECG is essential for diagnosing arrhythmias, myocardial infarction, conduction abnormalities, and other cardiac conditions. It is a fundamental tool in cardiology.

Learn more in our comprehensive RxDx Medicine Course

Indications

✓
Chest Pain

Suspected myocardial infarction

✓
Palpitations

Arrhythmia evaluation

✓
Syncope

Cardiac cause evaluation

✓
Preoperative Assessment

Cardiac risk evaluation

✓
Routine Screening

Cardiac health assessment

Contraindications

Absolute Contraindications

✗ Patient refusal

Relative Contraindications

✗ Severe skin conditions
✗ Allergy to electrodes

📋 Equipment Checklist

Check off items as you gather them:

Pre-procedure Preparation

Preparation includes patient explanation, skin preparation, and understanding the importance of proper lead placement.

Step-by-Step Procedure

Step 1: Patient Preparation

Explain procedure, position patient supine.

⚠️ Common Mistakes to Avoid:

  • Inadequate explanation
  • Poor positioning

💡 Pro Tip:

Position patient comfortably supine.

Step 2: Skin Preparation

Clean skin and remove hair if necessary.

⚠️ Common Mistakes to Avoid:

  • Inadequate cleaning
  • Poor preparation

💡 Pro Tip:

Use alcohol wipes for cleaning.

Step 3: Lead Placement

Apply electrodes in correct positions.

⚠️ Common Mistakes to Avoid:

  • Wrong placement
  • Poor contact

💡 Pro Tip:

Follow standard lead positions.

Step 4: Machine Setup

Set up ECG machine and calibrate.

⚠️ Common Mistakes to Avoid:

  • Wrong settings
  • Poor calibration

💡 Pro Tip:

Use standard settings.

Step 5: Recording

Record ECG with patient still.

⚠️ Common Mistakes to Avoid:

  • Movement artifacts
  • Poor quality

💡 Pro Tip:

Ensure patient remains still.

Step 6: Interpretation

Analyze ECG for abnormalities.

⚠️ Common Mistakes to Avoid:

  • Missed abnormalities
  • Wrong interpretation

💡 Pro Tip:

Use systematic approach.

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Post-procedure Care

Post-procedure care involves result interpretation, documentation, and appropriate clinical correlation.

Complications & Management

Complication Incidence Signs Management Prevention
Skin irritation 1-2% Redness, itching Topical steroids Gentle skin preparation
Allergic reaction 0.1-1% Rash, itching Antihistamines Check allergies
Artifact 5-10% Poor quality tracing Repeat recording Proper technique
Misinterpretation 1-3% Wrong diagnosis Expert review Systematic approach

Clinical Pearls

💡

Use systematic approach for interpretation.

🎯

Ensure proper lead placement.

⚡

Minimize movement artifacts.

🔍

Look for specific patterns.

📊

Correlate with clinical findings.

🎨

Document findings properly.

⚠️

Seek expert opinion for complex cases.