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aVR normally records negative deflections because it views the heart from the right shoulder, opposite the heart’s main electrical vector. Inverted P, QRS, and T waves in aVR are expected. Leads I, II, and III usually show positive deflections. Recognizing this prevents misinterpretation of normal findings as pathology.

Hypoglycemia or dehydration may cause dizziness, syncope, or abnormal stress test results. The test should be delayed until the patient is stable, and the supervising provider should be informed. Patient safety is the priority. Water alone may not be sufficient if hypoglycemia is suspected. Substituting a different test is not within the CCT’s scope without provider input.

Reversing the left arm (LA) and left leg (LL) leads alters limb lead orientation, creating abnormal Q waves or ST changes in inferior leads (II, III, aVF). This can mimic MI. Recognizing and correcting misplacements prevents misdiagnosis.

The QT interval represents the total time of ventricular depolarization and repolarization. It extends from the beginning of the QRS complex to the end of the T wave. A prolonged QT increases risk of torsades de pointes and sudden death. PR interval measures atrial depolarization through AV conduction. Understanding intervals helps CCTs identify conduction abnormalities and potential risk.

SVT is a narrow-complex tachycardia >150 bpm with abrupt onset and termination. P waves are often buried within QRS or T waves, making them difficult to see. Sinus tachycardia usually doesn’t exceed 150–160 bpm and shows visible P waves. Flutter shows sawtooth waves, and VT is wide-complex. Accurate recognition of SVT is essential to guide interventions like vagal maneuvers or adenosine therapy.