Course Content
Module 0 – Foundations
A basic understanding of cardiac anatomy and physiology is essential for effectively interpreting and understanding ECGs. This module covers key topics, including cardiac anatomy, the conduction system, the cardiac cycle, the ECG trace, the hexaxial reference system, and ECG paper.
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How to use this platform
01:21
Course overview
Heart anatomy
04:47
Heart Anatomy
Cardiac dominance
Cardiac dominance
Cardiac views and vascular territories
04:18
Cardiac conduction system
05:10
Abnormal cardiac conduction
03:20
Cardiac conduction
Cardiac cycle
06:02
Cardiac cycle
ECG trace
06:15
ECG trace
ECG waves correction
ECG waves
The hexaxial reference system
05:15
The hexaxial reference system
ECG paper
04:44
ECG paper
Foundations module summary
Module 0 - Foundations MCQ
Module 1 – Step 1 Analysing the rhythm
The heart's electrical activity must originate somewhere, and rhythm provides critical information about its origin, timing, and frequency. But what exactly is rhythm, and how do we describe it? This module explores these questions and more. You will practice analysing rhythm strips, describing rhythms on an ECG, and understanding the significance of the various elements observed when interpreting rhythm.
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What is rhythm?
05:31
What is rhythm
Analysing the rhythm
05:19
The heart rhythm
Analysing the rhythm
Rhythm examples
08:05
Rhythm examples
Polymorphic VT and TdP
Analysing the rhythm module summary
Analysing the rhythm module questions
Module 2 – Step 2 Describing the p wave
The p wave represents atrial depolarisation. What information can be gleaned from observing the p wave and what approach should one use when describing it? In this module you will practise how to describe the P wave and how to interpret your findings by looking at some examples.
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Describing the p wave
05:56
ECG waves (reminder)
P wave examples
03:28
Sinus rhythm and sinus arrythmia
Describing the P wave
Atrial fibrillation
06:50
Atrial fibrillation
A quick note about the 12 lead ECG
Module 3 – Step 3 PR interval
The PR interval essentially describes how the electrical impulse is conducted between atria and ventricles. What is a normal PR interval and what does an abnormal interval suggest? In this module you will learn to describe the PR interval and the PR segment using a systematic approach so that you can successfully answer these questions.
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The PR interval
PR interval 1 (heart blocks)
05:43
PR Interval 1 (heart blocks)
PR interval 2 (accessory pathways)
04:31
PR Interval 2 (accessory pathways)
PR interval 3 (junctional rhythms)
05:01
PR Interval (junctional rhythms)
PR interval 4 (AVRT and AVNRT)
05:05
AVRT and AVNRT
AVNRT vs AVRT
Tachyarrythmias
06:01
Module 3 Assessment
Module 4 – Step 4 Assessing the QRS complex
The QRS complex represents ventricular depolarisation. By examining the QRS complex, we can identify potential structural or conduction abnormalities within the ventricles. In this module, you will learn how to describe and analyse the QRS complex to detect and understand these abnormalities.
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The QRS complex
Cardiac axis
07:38
Cardiac axis
QRS complex – voltage etc
07:56
QRS complex - voltage etc
The Q wave
Example 12 lead ECGs 1
Module 5 – Step 5 ST segment and T wave
The ST segment and T wave relate to ventricular repolarisation. Similar to the QRS complex, analysing the ST segment and T wave can help identify potential structural or conduction abnormalities within the ventricles. In this module, you will learn how to describe this portion of the ECG trace and recognise common pathologies associated with abnormal ST segments and T waves, such as cardiac ischaemia and infarction.
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ST segment and T wave
07:26
ST segment & T wave
Acute coronary syndrome
Acute Coronary Syndrome
The QT interval
QT Interval
Normal waves, intervals, and segments
Approach to an ECG summary
Assessment
Storytelling
Example 12 lead ECGs 2
05:48
Case-based Assessment
Congratulations
Feedback & Claim CPD points
ECG Mastery Course
About Lesson

CARDIAC DOMINANCE

Cardiac dominance refers to which coronary artery supplies the posterior descending artery (PDA). The PDA supplies the inferior and posterior wall of the heart, the posterior portion of the interventricular septum and it typically supplies the AV node. There are largely 3 variations of cardiac dominance (A-C). These include:

  1. Right heart dominance (most common with a prevalence of 80-85%): Origin of the PDA is from the right coronary artery (RCA)
  2. Left heart dominance:  Origin of the PDA is from the left circumflex artery (LCx)
  3. Codominance: The PDA is supplied by both the right coronary artery (RCA) and the left circumflex artery (LCx)
  4. “Super-dominance” is a rare 4th variant where the left anterior descending artery supplies the PDA.

 
CLINICAL APPLICATION

Occlusion of the PDA may cause the following: inferior +- posterior infarction and decreased perfusion to the AV node which may present with an AV block (also known as a heart block).

 

REFERENCES

  • Shahoud JS, Ambalavanan M, Tivakaran VS. Cardiac Dominance. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537207/
  • Images modified using Servier Medical Art (https://smart.servier.com/) licensed under a Creative Commons Attribution 3.0 unported license (https://creativecommons.org/licenses/by/3.0/)
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