Interpret 12 lead ECG easily using these easy to remember tips. Locate Myocardial Infarction Accurately in all Areas. Lateral MI, Anterior MI, Posterior MI, Septal and Left Lateral wall MI.
I know – I know. 12 leads EKG remains one of those topics not so many nurses want to deal with. Learning how to read any 12 lead EKG presenting a myocardial infarction is a critical nursing skill every nurse should master.
This unbelievably easy way to interpret 12 lead EKG is only good for detecting the location of MI. In a future article, I will explain how to interpret conditions like cardiomegaly, right or left side congestive heart failure.
Are you ready to memorize these easy steps?
Step #1: Memorize all 12 Lead EKG Leads:
Get a plain piece of paper and write these leads numbers as they appear on the below diagram. The reason you are memorizing how to write them in this same sequence is because that is exactly how leads looks like on a 12 lead ECG paper.
Write these leads on a piece of paper as many times as it takes you to memorize this. You will be glad that you got this memorized because this is the first and most critical step to mastering 12 lead EKG interpretation for MI
To help you memorize these leads, notice leads I, II, and III follow each other in a vertical line on your left side.
Leads AVR, AVL & AVF comes next in the same sequence shown. To remember the correct sequence of the aV leads, remember this visual mnemonic.
The next two lines are taken by v leads from V1 to V6
Step#2 Highlight lead I and aVL:
Highlight lead I and aVL as shown in the diagram below followed by lead V5 & V6. These leads whenever showing ST elevation is indicative of Lateral MI but more about this in a minute.
Stay with me here
Step #3: Highlight/circle leads II, III and aVF
Remember the F stands for floor in our mnemonic above. Keep this between your fingers as well.
Step #4: Circle V1 & V2 leads as shown
Assume that is the mid-sagittal plane of the heart BUT the heart is not quite symmetrical as the left side is larger – remember?
Step #5: Join V3 & V4 leads as shown in the diagram below
Memorize this sequence over and over again until you can almost see this image with your eyes closed. Do it over and over again. Repetition is the mother of all skills. There is no better and easier way to address this elephant in the room called 12 lead EKG than memorizing this easy steps.
Step#6: Label all segments as shown below:
From here, watch this short video explanation over and over again. Trust me, if you only had 15-30 minutes, you will master 12 lead ECG interpretation and be able to locate where MI is occurring.
Notice that more than one highlighted areas could be elevated in a single EKG. This would show more than one area affected. This video is just to show you the basics of locating the affected areas of the heart.
Posterior wall MI, leads V1, V2 & V3 are depressed, NOT ELEVATED. Say that with me one more time J … v1-V3 are depressed.
Leave your comments and answer these two simple questions
- Where is MI occurring on this 12 lead ECG tracing?
- Where is the MI occurring in this EKG tracing?
See also, how to calculate mean arterial pressure MAP without memorizing the formula.
Resources: Life in the first lane