Heart Education Awareness Resource and Training through eLearning (HEARTe)

12 lead ECG examples

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Pulse point

12-lead ECG – posterior-lead placement:

V1 – V3 are moved round to become V7 – V9
They are placed on the same horizontal plane as V4
V7 Posterior axillary line
V8 Midscapular line in between V7 & V9
V9 To the left of the spine

Normal ECG

normal ECG graph — Reproduced with permission of Medtronic, Inc

Anterior STEMI

anterior STEMI graph — Reproduced with permission of Medtronic, Inc

ST elevation > 2mm in V1 -V4
Possible lateral involvement due to ST elevation in V5 and V6

For another example of Anterior STEMI see: Acute Coronary Syndrome: Case 2: Joan.

Inferior STEMI

Inferior STEMI graph — Reproduced with permission of Medtronic, Inc

ST elevation > 1mm in II, III and aVF
Minimal ST elevation in V6 suggesting possible lateral involvement
ST wave depression & T wave inversion in leads 1, aVL, V1-3

Lateral STEMI

Lateral STEMI — Reproduced with permission of Medtronic, Inc

ST elevation > 1mm in I and aVL

Posterior MI

posterior MI graph — Reproduced with permission of Medtronic, Inc

ST depression in V1 and V2
R wave in V2 suggestive of a posterior infarct

Bundle Branch Block

Identified by examining QRS width and morphology

Right Bundle Branch Block

right bundle branch block graph — Reproduced with permission of Medtronic, Inc

QRS>0.12 seconds
RSR’ in V1 and V2 with ST segment depressions and T wave inversion, deep slurred S wave in v6
QRS in V1 positive

Left Bundle Branch Block

left bundle branch block graph — Reproduced with permission of Medtronic, Inc

See Acute Coronary Syndrome: Case 3: Naveed

QRS > 0.12 seconds
Depolarisation of the septum occurs from right to left
Q wave in V1
R wave in V6

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12 Lead ECG Interpretation

Page last reviewed: 30 Jul 2020