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    ELECTROCARDIGORAM

    Uploaded by

    anju rachel jose
    The document discusses the basics of electrocardiography including the electrical and mechanical events of the heart, limb and chest leads, ECG paper, PQRST intervals, axis determination, myocardial infarction, electrolyte imbalances, and more. Key topics covered include the normal ECG patterns, signs of MI like ST elevation, reciprocal changes, and Q waves, as well as conditions like left atrial hypertrophy, right ventricular hypertrophy, and electrolyte abnormalities.

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    © All Rights Reserved
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    ELECTROCARDIGORAM

    Uploaded by

    anju rachel jose
    16 views78 pages
    The document discusses the basics of electrocardiography including the electrical and mechanical events of the heart, limb and chest leads, ECG paper, PQRST intervals, axis determination, myocardial infarction, electrolyte imbalances, and more. Key topics covered include the normal ECG patterns, signs of MI like ST elevation, reciprocal changes, and Q waves, as well as conditions like left atrial hypertrophy, right ventricular hypertrophy, and electrolyte abnormalities.

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    The document discusses the basics of electrocardiography including the electrical and mechanical events of the heart, limb and chest leads, ECG paper, PQRST intervals, axis determination, myocardial infarction, electrolyte imbalances, and more. Key topics covered include the normal ECG patterns, signs of MI like ST elevation, reciprocal changes, and Q waves, as well as conditions like left atrial hypertrophy, right ventricular hypertrophy, and electrolyte abnormalities.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    16 views78 pages

    ELECTROCARDIGORAM

    Uploaded by

    anju rachel jose
    The document discusses the basics of electrocardiography including the electrical and mechanical events of the heart, limb and chest leads, ECG paper, PQRST intervals, axis determination, myocardial infarction, electrolyte imbalances, and more. Key topics covered include the normal ECG patterns, signs of MI like ST elevation, reciprocal changes, and Q waves, as well as conditions like left atrial hypertrophy, right ventricular hypertrophy, and electrolyte abnormalities.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    of 78

    ELECTROCARDIOGRAM

    ELECTRICAL & MECHANICAL EVENTS OF HEART


    LIMB LEADS & CHEST LEADS
    E.C.G Paper
    Basic laws of ECG
    • If the impulse(vector/current) moving towards the
    positive pole of a lead it will create a +ve
    deflection in that lead
    • If the impulse (vector/current) is moving away
    from the positive pole (towards negative pole)
    it will create a negative deflection in that lead
    PQRST Represents
    PQRST duration

    P 2.5mm = 0.1sec
    QRS 1- 2.5mm = 0.04 – 0.1sec (0.08sec)
    PR-Interval 3 – 5mm = 0.12 – 0.2sec,
    T - 6.2 – 7.5mm = 0.25-0.3sec
    -height-1/3 of QRS
    QT-Interval- 8.7-10.5mm = 0.35-0.42sec
    J -Point

    Isoelectric line
    Look for elevation/depression of ST
    compare with TP line
    ST TP
    R wave progression in chest leads
    CALCULATION OF HEART RATE

    1. Calculate heart rate- number of QRS complexes in one minute


    i.e. - ___________1500______________________
    no. of small squares in between two R waves.
    or ____________300_________________________
    no. of large squares in between two R waves.

    if rhythm is irregular .
    count the QRS complexes in a 6 second strip and multiply that with 10.
    NORMAL AXIS
    • Lead I,QRS is positive(upward)

    • AVF & Lead II, QRS is positive (upward)


    Right axis deviation
    • Lead I ,QRS is negative( downward)

    • AVF& Lead II , QRS is positive(Upward)


    Left Axis deviation
    • Lead I, QRS is positive(Upward)

    • AVF & Lead II ,QRS is negative


    (downward)
    ECG READING
    1.Standardisation

    2.Rhythm-regular/irregular

    3.Check the P-P interval and RR interval regularity.

    4.Calculate heart rate

    5.Examine P wave-presence, position with respect to QRS, and shape

    6. Measure PR interval

    7.Abnormal Q wave

    8. QRS complex – width, shape,voltage,

    9.Precordial R wave progression

    10. Examine ST – segment-ST elevation or ST depression

    11. T wave-height- ( 1 rd of QRS ) upright


    3
    -look for T wave inversion.

    12.QT interval

    13. U wave
    14.Axis determination
    Uses of ECG
    MI
    • STEMI
    • NSTEMI
    STEMI

    • Indicative changes
    • reciprocal changes
    Indicative changes

    • ST elevation - zone of injury


    • T wave inversion - zone of ischaemia

    • R wave progression in chest leads may not be there

    • After 2- 3 days Q wave appear - zone of necrosis


    Reciprocal Changes in MI
    Mirror image of indicative change

    II, III, aVF


    I, aVL, V leads
    RECIPROCAL CHANGES
    • Tall R wave

    • ST depression

    • Upright T wave
    Hyperacute MI

    Tall T wave may be the first change


    Myocardial Infarct (MI)
    Inferior Wall

    I aVR V1 V4
    II aVL V2 V5
    III aVF V3 V6
    Inferior Wall

    (RCA)
    ECG-MI
    SEPTAL MI
    • V1,V2
    Anterior Wall
    • V3, V4
    – Left anterior chest

    I aVR V1 V4

    V2
    II aVL V5
    III aVF V3 V6

    (LAD)
    Lateral
    • I, aVL, V5, V6

    Lateral Wall

    aVR V1 V4
    I
    (Circumflex) aVL V2 V5
    II
    aVF V3 V6
    II

    I
    posterior wall MI
    • Reciprocal changes in V1, V2
    Right ventricular MI
    NSTEMI
    ECG- ELECTROLYTE IMBALANCE
    hypokalemia
    • Presence of prominent U wave
    • Flattened Twave
    • ST depression
    • Ventricular arrhythmias(PVC s)
    hypocalcaemia

    • Prolonged QT interval
    hypercalcaemia

    • Shortened QT interval
    RAH
    Left atrial hypertrophy

    Left atrial enlargement


    – Take a look at this ECG. What do you notice about the P waves?

    The P waves in lead II are notched and in lead V1 they have a deep and wide
    negative component.
    Right ventricular hypertrophy
    R wave progression-normal
    THANK YOU
    Axis
    NORMAL AXIS
    • Lead I,QRS is positive(upward)

    • AVF & Lead II, QRS is positive (upward)


    Right axis deviation
    • Lead I ,QRS is negative( downward)

    • AVF& Lead II , QRS is positive(Upward)


    LEFT AXIS DEVIATION
    • Lead I, QRS is positive(Upward)

    • AVF & Lead II ,QRS is negative


    (downward)

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