This chapter presents a structured and clinically oriented approach to electrocardiogram (EKG) interpretation and the management of key cardiac conditions. Efficient EKG analysis begins with determining heart rate using lead II, followed by rhythm evaluation to confirm sinus origin, axis determination through leads I and AVF, and identification of conduction abnormalities such as bundle branch blocks. Further analysis includes detecting chamber enlargement, ischemic changes, and segmental interval abnormalities (PR, QRS, QT, T waves) that may suggest electrolyte imbalances or structural disease. Tachyarrhythmias are classified into narrow or broad complex types, with diagnostic differentiation aided by waveform patterns and clinical context. The chapter also covers acute atrial fibrillation (AF) management, stressing rapid assessment, rhythm or rate control, and stroke prevention through appropriate anticoagulation. Inherited cardiac channelopathies, including Long QT, Brugada, and catecholaminergic polymorphic VT, are explored with attention to genetic origins and arrhythmic risk. Preoperative considerations for patients with cardiac pacemakers are outlined, emphasizing device interrogation and perioperative planning to avoid electrical interference. Finally, cardiac heart blocks are reviewed, from first-degree to complete AV block, with a focus on clinical presentation and pacemaker indications. Altogether, the content reinforces the integration of EKG interpretation, clinical evaluation, and individualized treatment in managing both acute and chronic cardiac conditions.