Is my EKG report normal?

From Lena Machetanz, doctor
All NetDoktor content is checked by medical journalists.

In the ECG evaluation the doctor assesses the characteristic curves that are generated by electrical excitation of the heart and that are recorded by the EKG machine. Each ECG curve reflects a specific phase of the heart's action. This allows the doctor to check whether the heart is working normally. Read everything about the ECG evaluation and possible ECG changes.

ECG diagnosis: classic elements

A normal EKG consists of the following patterns, each of which reflects a specific phase of the heart's action. A so-called EKG ruler serves as an aid for interpreting the curves:

  • P wave: spread of excitation in the atria
  • PQ time: transition from the atria to the ventricles
  • QRS complex: excitation processing of the chambers, the Q wave corresponds to the beginning of the chamber excitation
  • ST segment: regression of the ventricles
  • T wave: excitation regression of the atria
  • QT time: total excitation time of the chambers
  • U-wave: occurs only sometimes, usually without any disease value

In patients with a cardiac pacemaker, the EKG has a fundamentally different appearance because it is not the sinus node but the pacemaker that sets the beat of the heart.

EKG: position type

When interpreting the ECG, the doctor can also determine the direction in which the excitation is spreading, the so-called location type. The following types of positions can be found in the ECG:

  • Steep type (normal, especially in young, slim adults)
  • Indifference type
  • Link type
  • Legal type
  • overturned link type
  • overturned right type

While steep, left and indifference types are normal (physiological) in healthy adults, some types of position also suggest a disease. Causes for a deviation of the heart axis to the left are, for example, obesity, left heart strain or posterior infarction. A deviation to the right, on the other hand, is found with right heart loading or an enlarged right ventricle.

EKG: sinus rhythm and arrhythmias

The normal rhythm of the heart is called sinus rhythm. If the doctor wants to evaluate the EKG, he pays attention to various criteria that speak for normal stimulus conduction in the heart and for a sinus rhythm. This includes regular P-waves with regular intervals between them. Each P-wave should be followed by a QRS complex.

An irregular sinus rhythm that occurs in the ECG evaluation is noticeable is called sinus arrhythmia. If the heart beats in a regular sinus rhythm, but too slowly, it is called sinus bradycardia, if the heartbeat is too fast, it is called sinus tachycardia.

Author & source information