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    ECGs For Beginners

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    Yair Myat Hane
    This document provides an overview of key concepts for interpreting electrocardiograms (ECGs), including how to assess the rate, rhythm, axis, signs of hypertrophy, evidence of infarction or ischemia, and fatal ECG patterns. It explains how to calculate the heart rate based on the rhythm and use of the ECG grid. Common rhythms like atrial fibrillation, supraventricular tachycardia, ventricular tachycardia are demonstrated. Features of left or right axis deviation, left or right ventricular hypertrophy, and locations of myocardial infarction are outlined. Tracings show examples of subendocardial ischemia, inferior or anterior MIs, non-ST elevation MIs, and old MIs

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    ECGs For Beginners

    Uploaded by

    Yair Myat Hane
    37 views89 pages
    This document provides an overview of key concepts for interpreting electrocardiograms (ECGs), including how to assess the rate, rhythm, axis, signs of hypertrophy, evidence of infarction or ischemia, and fatal ECG patterns. It explains how to calculate the heart rate based on the rhythm and use of the ECG grid. Common rhythms like atrial fibrillation, supraventricular tachycardia, ventricular tachycardia are demonstrated. Features of left or right axis deviation, left or right ventricular hypertrophy, and locations of myocardial infarction are outlined. Tracings show examples of subendocardial ischemia, inferior or anterior MIs, non-ST elevation MIs, and old MIs

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    ECGs for Beginners

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    This document provides an overview of key concepts for interpreting electrocardiograms (ECGs), including how to assess the rate, rhythm, axis, signs of hypertrophy, evidence of infarction or ischemia, and fatal ECG patterns. It explains how to calculate the heart rate based on the rhythm and use of the ECG grid. Common rhythms like atrial fibrillation, supraventricular tachycardia, ventricular tachycardia are demonstrated. Features of left or right axis deviation, left or right ventricular hypertrophy, and locations of myocardial infarction are outlined. Tracings show examples of subendocardial ischemia, inferior or anterior MIs, non-ST elevation MIs, and old MIs

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    37 views89 pages

    ECGs For Beginners

    Uploaded by

    Yair Myat Hane
    This document provides an overview of key concepts for interpreting electrocardiograms (ECGs), including how to assess the rate, rhythm, axis, signs of hypertrophy, evidence of infarction or ischemia, and fatal ECG patterns. It explains how to calculate the heart rate based on the rhythm and use of the ECG grid. Common rhythms like atrial fibrillation, supraventricular tachycardia, ventricular tachycardia are demonstrated. Features of left or right axis deviation, left or right ventricular hypertrophy, and locations of myocardial infarction are outlined. Tracings show examples of subendocardial ischemia, inferior or anterior MIs, non-ST elevation MIs, and old MIs

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    ECGs for Beginners

    Soe Chan Myae


    Rate
    Rhythm
    Axis
    Hypertrophy
    Infarct & ischaemia
    Fatal ECGs
    RATE
    If regular
    300/RR in large squares.
    If irregular or bradycardia
    Cycles/6 sec. strip X 10
    1 sec = 1 cycle = 5 large squares
    No. of R in 30 large squares × 10
    RHYTHM
    P before QRS

    PR internal for AV blocks. Normal 120 -200


    ms
    R- R interval equal
    If (-) P wave look QRS complex
     Narrow QRS ( atrial rhythm,supraventricular
    rhythm) ,
    Wide QRS( (ventricular rhythm, atrial rhythm
    with heart block)
    AF
    AF
    SVT
    VT
    AXIS
    Normal axis
    Upward in I & avF
    LAD
    Upward in I & downward in avF
    Cause – IHD ,LVH
    RAD
    Downward in I & Upward in avF
    Causes Mitral stenosis,Chronic lung
    disease ,RVH
    Extreme axis
    Downward in I & avF
    LAD
    HYPERTROHY
    Atrial
    P wave
    Ventircle
    QRS complex
    Left atrial enlargement

     The P wave in lead II is broad and substantially


    notched, while V1 reveals a deeply inverted
    (negative) P wave.
    Right atrial enlargement

    Delayed activation of an enlarged right atrium


    leads to simultaneous activation of the right
    and left atria; this results in a relatively
    narrow P wave which is of increased amplitude.
    Left ventricular hypertrophy

     This electrocardiogram demonstrates several features


    of left ventricular hypertrophy: the QRS complex is
    slightly widened due to an intraventricular
    conduction delay; there is left axis deviation; there
    is ST depression and inverted T waves noted in
    several leads; several voltage criteria are met,
    including an R wave in aVL which is greater than 18
    Right ventricular hypertrophy

     The right ventricular forces become predominant in


    patients with right ventricular hypertrophy (RVH),
    producing tall R waves in the right precordial leads (V1
    and V2), and deep S waves in the left precordial leads
    (V5 and V6); a R:S ratio >1 in V1 and V2 is suggestive of
    RVH. Other features in this case include right axis
    deviation and RV1 >7 mm.
    INFARCT & ISCHAEMIA
    Diffuse subendocardial
    ischemia

    Diffuse subendocardial ischemia manifested by prominent ST


    depressions in leads I, II, aVL, aVF, and V2 to V6, with ST elevation
    in aVR. A prolonged PR interval (0.28 sec) is also present.
    ventricular myocardial
    infarction

    Electrocardiogram shows Q waves and prominent doming ST segment


    elevation in II, III, and aVF, findings which are characteristic of an acute inferior
    myocardial infarction. ST elevation in the right precordial leads - V4R, V5R,
    and V6R Ñ indicates right ventricular involvement as well (arrows). The ST
    depressions in leads I and aVL represent reciprocal changes.
    Inferior MI with anterior
    ischemia

    Electrocardiogram showing ischemic changes in two areas of the


    myocardium: inferior myocardial infarction (Q waves and ST elevations in
    leads II, III, and aVF); and anterior ischemia (ST depressions in leads V2
    and V3).
    Inferior MI
    Persistent ST segment
    elevation post-MI

    The presence of an anterior wall aneurysm following an acute myocardial


    infarction is suspected because of persistent ST elevation in leads V2 to V4.
    Inverted T waves are evidence of the old infarct.
    Anterior MI
    NSTEMI
    Days old MI
    Fatal ECGs
    Electroytes changes
    PE
    Hyperkalemia
    Hypokalemia
    Hypocalcemial long QT
    interval
    PE
    Thank You

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