## How to read an EKG? Use the basic method by Dr. ROIG.

In the beginning, most physicians, nurses and students experience problems when performing an adequate interpretation of an EKG, and this is due (among other factors) to the lack of organization when interpreting an EKG.

To solve this GLOBAL problem, Dr Roig created a basic method that will guide you in a simple way. The only thing you have to do, is to remember his last name (**ROIG**).

Now we will explain the steps of the ROIG method and then we will use one sample to see how it works.

Use the __basic__ method by Dr. ROIG by remembering his last name.

**R****ate**

**O****bserve the rhythm**

**I****ntervals**

**G****o for the signs of Myocardial Infarction**

Each person has their way of reading an EKG, but if you don't have a specific order, the basic method of Dr. ROIG will help you organize yourself every time you interpret an EKG. As soon your knowledge increases, you should add to the method (second step) the following:

**O**bseve the rhythm, P:QRS, Axis, Voltage, R progression, and the Chambers enlargment.

After knowing the method, I think we are in a position to see how it works.

Example 1:

Use the __basic__ method by Dr. ROIG by remembering his last name.

**R**ate

The first step is to calculate the Heart Rate (HR).

Total QRS x 6 = HR.

If HR > 100 bpm = Tachycardia.

If HR < 60 bpm = Bradycardia.

**O**bserve the rhythm

The second step is to observe the rhythm.

If R-R interval is equal = Regular rhythm.

If R-R interval varies = Irregular rhythm.

If P wave is upright in lead II = Sinus rhythm.

**I**ntervals

The third step is to analyze the intervals.

Check the PR, QRS and QT intervals.

Are they long o short?

**G**o for the signs of Myocardial Infarction (MI).

The fourth step is to look for MI.

Are there ST elevation?

Are there ST depression in V1-V3?

Are there abnormal Q waves?

**EKG Interpretation **

Rate: 12 QRS x 6 = 72 bpm (Normal)

Regular rhythm (R-R interval is equal).

Sinus rhythm (upright P wave in lead II)

The intvervals PR, and QT are normal. The QRS is < 0.12 seconds with rSr' pattern in V1 and V2.

No signs of myocardial infarction (absent of ST elevation/depression and absent of Q waves).

The EKG (Example 1) shows a sinus rhythm at a rate of 72 bpm with an incomplete RBBB (right bundle branch block).

Example 2:

Use the __basic__ method by Dr. ROIG by remembering his last name.

**R**ate

The first step is to calculate the Heart Rate (HR).

Total QRS x 6 = HR.

If HR > 100 bpm = Tachycardia.

If HR < 60 bpm = Bradycardia.

**O**bserve the rhythm

The second step is to observe the rhythm.

If R-R interval is equal = Regular rhythm.

If R-R interval varies = Irregular rhythm.

If P wave is upright in lead II = Sinus rhythm.

**I**ntervals

The third step is to analyze the intervals.

Check the PR, QRS and QT intervals.

Are they long o short?

**G**o for the signs of Myocardial Infarction (MI).

The fourth step is to look for MI.

Are there ST elevation?

Are there ST depression in V1-V3?

Are there abnormal Q waves?

**EKG Interpretation**

Rate: 20 QRS x 6 = 120 bpm (Tachycardia because HR > 100 bpm).

Regular rhythm (R-R interval is equal).

Sinus rhythm (upright P wave in lead II).

The intvervals PR, QRS and QT are normal.

Are there ST elevation?. There is ST elevation in II, III and aVF with reciprocal changes (ST depression) in aVL. In addition, notice the inverted T waves in the same leads.

Are there ST depression in V1-V3?. No

Are there abnormal Q waves?. There are abnormal Q waves in II, III and aVF.

This EKG (Example 2) shows sinus tachycardia at a rate of 120 bpm with inferior Q wave myocardial infarction (Acute).

I hope this method will be useful for you as much as it was for me in the beginning.

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