ST elevation in Leads 1, 2, etc.

[str8flexed]

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I never learned the difference in leads, etc. I know they correlate with different parts of the heart. Is it important to know them for boards? In World, you can figure out the answer with other clues in the question.

 

[Rendar5]

II, III, and aVF correlate to an inferior MI. I and aVL are lateral MI. I doubt you have to distinguish the pre-chordial leads at your level.

EDIT: You shouldn't really be worrying about being able to read EKGs until your clinical years, and you don't really need to know the location of all the leads really well unless you're going into EM, cardiology, or some other field where localizing the MI would be important to patient management.

 

[McGillGrad]

There are only a couple situations (stated in the post above) where the leads point toward a specific pathology but most questions have additional clues.

 

[HopefulDoc1984]

We have to be able to fluently interpret any EKG. SVTA, RNVT, MI, hyop/hyperkalemia, WPW, LGL, All Blocks, hypertropy/dilation of any chamber...................... Where do you guys go to school that you don't need to learn this stuff.

 

[McGillGrad]

We have to be able to fluently interpret any EKG. SVTA, RNVT, MI, hyop/hyperkalemia, WPW, LGL, All Blocks, hypertropy/dilation of any chamber...................... Where do you guys go to school that you don't need to learn this stuff.

Somewhere that teaches medicine, not being an EKG tech.

 

[HopefulDoc1984]

Somewhere that teaches medicine, not being an EKG tech.

yea, cause doctors shouldnt be able to read their own EKGs.

 

[McGillGrad]

yea, cause doctors shouldnt be able to read their own EKGs.

Oh, you're a doctor already? I though that you were in med school?

 

[HopefulDoc1984]

Oh, you're a doctor already? I though that you were in med school?

That's the point. I am learning how to be a great doctor and not one who thinks that an EKG tech should give me a diagnosis.

 

[McGillGrad]

That's the point. I am learning how to be a great doctor and not one who thinks that an EKG tech should give me a diagnosis.

The difference is that you can learn to interpret EKGs during rotations and during internship when you are still not a licensed physician. Your job as a medical student is to understand the mechanism, physiology and pathology of the reading because there is no time to learn all of that after basic sciences.

You are confusing rudimentary EKG readings with the science behind the patterns. The patterns take a day to teach on the wards.

Finally, this is a step I board and on step I you do not need more than FA level to confirm your answer.

 

[Rendar5]

We have to be able to fluently interpret any EKG. SVTA, RNVT, MI, hyop/hyperkalemia, WPW, LGL, All Blocks, hypertropy/dilation of any chamber...................... Where do you guys go to school that you don't need to learn this stuff.

You're on the step 1 boards forum, you're not on the allopathic forum or the clinical years forum. There is absolutely no reason to learn this stuff before 3rd year. You won't be tested on this stuff and you're not expected to learn it in the first 2 years. But, there is absolutely every reason to learn that stuff by the time you are a functioning resident.

 

[psammomabody]

In response to the OP's question, here are the basics:

Inferior MI shows ST changes in leads II, III, and aVF and is usually associated with blockage of the right coronary artery.

Lateral MI shows changes in leads V5, V6, and sometimes I and III and is associated with blockage in the left circumflex.

Anterior MI shows changes in leads V1-V4 and possibly V5/V6 and is associated with left anterior descending pathology.

Left main blockage would cause LAD and LCX disease.

If they asked you something like this on step 1 they would probably tell you the leads (i.e., "ST elevation was noted in leads II, III, and aVF"). They most likely would not have you actually interpret the ECG.

 

[Rendar5]

The must-know short list of EKG concepts of Northwestern Medical Review includes the following: identifying the mean axis of heart depolarization; atrial and ventricular hypertrophy (left and right); hypo and hyperkalemia; hypo and hypercalcemia; transmural and subendocardial infarction; myocardial ischemia (acute and chronic); atrial flutter and fibrillation; and V-fib. 🙂

I hope that's not a step I list? and y'know, for the life of me i cna't remember what hypocalcemia looks like? But the rest of that is a fairly important list, I'd add SVT and heart blocks to it