(Updated November 1, 2023)

Electrocardiograms are similar to those encountered in a typical medical director’s day. Many of these are covered in the Triennial Course in the EKG section. The candidate should be familiar with the following EKG patterns (note that this list is not all inclusive):

Normal sinus rhythm

Pacemaker

Wandering atrial pacemaker

Junctional rhythm

Premature atrial contraction (PAC)

Premature ventricular contraction (PVC) – single, couplets, multifocal, bigeminy

Sinus tachycardia

Sinus bradycardia

Supraventricular tachycardia

Ventricular tachycardia

Atrial fibrillation/Atrial flutter

First degree atrioventricular block (AVB)

Second degree atrioventricular block (AVB) – Mobitz I or Wenckebach, Mobitz II

Third degree atrioventricular block (complete heart block)

Wolff-Parkinson White (WPW)

Prominent p waves suggesting cor pulmonale or right atrial enlargement

Left atrial enlargement

Inferior wall myocardial infarction

Lateral myocardial infarction

Septal myocardial infarction

Anterior wall myocardial infarction

Posterior wall myocardial infarction

Poor R wave progression in V leads

LVH voltage

Low voltage

Right axis deviation

Left axis deviation

Exercise ECG positive/suggestive of ischemia

T wave flattening (minor changes)

T wave inversions (major changes)

ST elevation consistent with infarction

ST elevation consistent with early repolarization

ST elevation consistent with pericarditis

Complete right bundle branch block

Complete left bundle branch block

Intraventricular conduction delay, indeterminate

Incomplete right bundle branch block

Bifasicular block

Double paper speed

Limb lead reversal

Double standardization

Half standardization

60 cycle interference/other artifact