E C G
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The document provides information about electrocardiography (ECG) including what it is, how it works, the normal components and intervals seen on an ECG, abnormalities that may be seen, and tips for performing an ECG. It discusses how ECG can be used to evaluate the heart's electrical conduction system and identify cardiac abnormalities.
E C G
- 4. E C G THECAMERA • A noninvasive electrocardiographic representation of biophysiological status of myocardium . • ECG is the simplest way to take the photograph of heart in different directions to get a clear picture of it .
- 5. • Current flowing in the heart via the pacemakers to heart is to be recorded via the leads. V = iR ohms law • Current (i) is low but with high resistance the voltage outcome is made too large so that it can be recorded .
- 6. 6 Normal Impulse Conduction Sinoatrial node AV node Bundle of His Bundle Branches Purkinje fibers
- 9. LEADS • Unipolar leads –V1 ,V6 • Bipolar leads – I ,II,III –VL ,VR ,VF –aVL ,aVR ,aVF
- 13. Number of large boxes divided by 300. 300,150,100,80,75,60,50. Rate 150bpm
- 14. • Sinus rhythm –P wave followed by QRS complex in lead II, III, aVF, V5, V6 • Ventricular rhythm • Fibrillation • Flutter
- 15. Sinus rhythm
- 16. • This is the vector of the heart in toto ,hence in simple terms it can be deducted by the lead I, aVF LEAD AXIS AXIS AXIS AXIS I + - - + aVF + - + - REPORT NORMAL EXTREME RAD RAD LAD
- 17. - ve + ve
- 18. • RIGHT ATRIUM : Height in leads V1 ,II. • LEFT ATRIUM : Width in leads V1 ,II. • RIGHT VENTRICLE : If R > S for 1 small square in V1. • RVH with STRAIN : RVH with T wave inversion • Left ventricle : Cornell Voltair Crieteria –aVL “R” + V3 “S” > 20 in female or >28 in males • LVH with STRAIN : LVH with T wave inversion
- 19. NORMAL CHAMBERS RIGHT ATRIUM : Height of P leads V1 ,II. LEFT ATRIUM : Width of P in leads V1 ,II. RIGHT VENTRICLE : If R > S for 1 small square in V1. Left ventricle : Cornell Voltair Crieteria aVL “R” + V3 “S” > 20 in female or >28 in males
- 20. • P wave : 0.2 seconds • PR interval : 0.12 -0.2 seconds • QRS complex : 0.06 – 0.10 seconds • QT interval : less than half of the RR interval • ST interval : • ST character • T wave : • R – R progression :
- 22. To do • Patient to be in rest. • Respirations should not be voluntarily to intense . • See electrodes are not loose. • Shave the hair if possible at electrodes area . • Place nothing on the bed ,don’t touch the bed while taking ECG . • Maitain the paper speed ,don’t change default settings
- 23. Effect of reversing electrodes RL
- 24. Effect of poor electrode contact bizarre QRS
- 26. Effect of pattern of respiration
- 27. Effect of stray potentials
- 28. Effect of electrical interfernce
- 29. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : 76 BPM SINUS NORMAL NORMAL
- 30. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : 150 BPM SINUS NORMAL NORMAL Exercise, Anxiety, Fever, Hypoxemia, Hypovolemia, Or Cardiac Failure.
- 31. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : 48 BPM SINUS NORMAL NORMAL In acute MI, it may be protective and beneficial or the slow rate may compromise cardiac output. Certain medications, such as beta blockers, may also cause sinus bradycardia.
- 34. ST segment elevation 1 mm in the limb leads and 2 mm in the chest leads
- 38. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : 150 BPM SINUS,SINUS PAUSE NORMAL NORMAL Cardiac output may decrease, causing syncope or dizziness..
- 39. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : 76 BPM SINUS,DROPPED BEAT NORMAL NORMAL
- 40. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : 150 BPM NO P WAVE ? NORMAL NO P WAVE, NO PR
- 41. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : 300 BPM,IRREGULAR ? SINUS ? NORMAL NO P WAVE, NO PR Sudden onset of SVT
- 42. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : ATRIA :300;VENTRICULAR 100 ? SINUS ? NORMAL PR VARIALBLE Sudden onset of SVT
- 43. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : ATRIA : >350 ;VENTRICULAR 60-150 . NOT SINUS ? NORMAL PR NONE Irregular R-R intervals
- 44. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : 20. NOT SINUS ? NORMAL PR NONE Irregular R-R intervalsagonal rhythm
- 45. RATE : RHYTHM : CHAMBERS : INTERVALS AND SIGNIFICANCE : 70. NOT SINUS WHEN PVC OCCURS ? NORMAL PR NORMAL ,QRS BIZARRE
- 48. • pUlmonary Embolism, MI, Acidosis, Tension Pneumothorax, Hyper- and Hypokalemia, Cardiac Tamponade, Hypovolemia, Hypoxia,hypothermia, and Drug Overdose (I.E., Cyclic Antidepressants, Beta Blockers, Calcium Channel Blockers, Digoxin).
- 49. • RULE OUT V FIB. • SEE IT NOT LESS THAN TWO LEADS .
- 50. Atrial pacemaker spike • Ventricular pacemaker spike Pacemaker spike
- 51. SUMMARY• WHAT IS IT ? • HOW IS IT ? • HOW TO DO IT ? • WHEN TO DO IT ? • HOW TO NOT DO IT ? • WHY SHOULD I DO IT ? • WHAT DOES IT ? • IS ECG EVERYTHING ? • LEAR A LOT MORE……..