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    BASIC ECG READING For Nle NOVEMBER 2018

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    Sharmaine Kimmayong
    This document provides an overview of basic electrocardiography (ECG or EKG) including cardiac anatomy, physiology, the development of the ECG machine, the 12 lead system, common ECG waves and intervals, normal sinus rhythm, various arrhythmias including atrial and ventricular tachycardias, and how to interpret ECG readings. It describes the typical appearance of P waves, PR intervals, QRS complexes, and other aspects of the ECG tracing for normal sinus rhythm as well as various arrhythmias such as atrial fibrillation, premature ventricular contractions, heart blocks, and more.

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    Download as PPTX, PDF, TXT or read online from Scribd

    BASIC ECG READING For Nle NOVEMBER 2018

    Uploaded by

    Sharmaine Kimmayong
    159 views63 pages
    This document provides an overview of basic electrocardiography (ECG or EKG) including cardiac anatomy, physiology, the development of the ECG machine, the 12 lead system, common ECG waves and intervals, normal sinus rhythm, various arrhythmias including atrial and ventricular tachycardias, and how to interpret ECG readings. It describes the typical appearance of P waves, PR intervals, QRS complexes, and other aspects of the ECG tracing for normal sinus rhythm as well as various arrhythmias such as atrial fibrillation, premature ventricular contractions, heart blocks, and more.

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    This document provides an overview of basic electrocardiography (ECG or EKG) including cardiac anatomy, physiology, the development of the ECG machine, the 12 lead system, common ECG waves and intervals, normal sinus rhythm, various arrhythmias including atrial and ventricular tachycardias, and how to interpret ECG readings. It describes the typical appearance of P waves, PR intervals, QRS complexes, and other aspects of the ECG tracing for normal sinus rhythm as well as various arrhythmias such as atrial fibrillation, premature ventricular contractions, heart blocks, and more.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    159 views63 pages

    BASIC ECG READING For Nle NOVEMBER 2018

    Uploaded by

    Sharmaine Kimmayong
    This document provides an overview of basic electrocardiography (ECG or EKG) including cardiac anatomy, physiology, the development of the ECG machine, the 12 lead system, common ECG waves and intervals, normal sinus rhythm, various arrhythmias including atrial and ventricular tachycardias, and how to interpret ECG readings. It describes the typical appearance of P waves, PR intervals, QRS complexes, and other aspects of the ECG tracing for normal sinus rhythm as well as various arrhythmias such as atrial fibrillation, premature ventricular contractions, heart blocks, and more.

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    © All Rights Reserved
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    BASIC ECG

    READING
    DR. ELENITA C. MANRIQUE - ARREGLO
    CARDIAC ANATOMY
    CARDIAC ANATOMY
    CARDIAC ANATOMY
    CARDIOPHYSIOLOGY
    THE
    ELECTROCARDIOGRAPH
     GRAPHIC REPRESENTATION OF CARDIAC ACTIVITY
    WILLEM EINTHOVEN
    THE FIRST ECG
    THE LEADS
    LEADS CAPTURING
    IMPULSES
    LEADS

     12 LEAD VIEWS OF THE HEART


     LATERAL WALL – I,AVL, V5,V6
     INFERIOR WALL – II, III, AVF
     ANTERIOR WALL – V1, V2, V3, V4
     SEPTUM – V1, V2
     POSTERIOR WALL – RECIPROCAL
    CHANGES IN V1, V2 (SOMETIMES V4)
    EVOLUTION
    NEW GENERATION
    MOST COMMON
    ECG WAVES
    ECG TRACING
    ECG READING
     P WAVE
     LOCATION : PRECEEDS QRS COMPLEX
     AMPLITUDE : 2 – 3 mm
     DURATION : 0.06 – 0.12 sec
     CONFIGURATION : ROUNDED AND
    UPRIGHT
     P – R INTERVAL
     LOCATION : FROM BEGINNING OF P TO
    THE BEGINNING OF QRS
     DURATION : 0.12 – 0.20 sec
     QRS COMPLEX
     LOCATION: FOLLOWS P – R INTERVAL
     AMPLITUDE : 5 – 30 mm high
     DURATION: 0.06 – 0.10 sec
    ECG READING
     ST SEGMENT
     LOCATION: EXTENDS FROM THE S WAVE
    TO THE BEGINNING OF THE T WAVE
     DEFLECTION : USUALLY ISOELECTRIC
     QT INTERVAL
     FROM THE START OF THE Q TO THE END OF
    THE T WAVE
     0.36 TO 0.44 SECOND
     T WAVE
     LOCATION: FOLLOWS THE S WAVE
     AMPLITUDE: 0.5 mm IN LEADS I, II, III up
    to 1o mm in precordial leads
     CONFIGURATION: ROUND AND
    SMOOTH
     DEFLECTION: USUALLY UPRIGHT IN I, II,
    V3 TO V6 INVERTED IN AVR, VARIABLE
    IN OTHER LEADS
     U WAVE
     LOCATION : FOLLOWS T WAVE
     CONFIGURATION: UPRIGHT AND
    ROUNDED
     DEFLECTION: UPRIGHT
     INDICATIONS
    CORONARY ARTERY
    DISEASE
    MYOCARDIAL INFARCTION
    CARDIOMEGALY
    CARDIOMEGALY
    Electrolyte imbalances
    Heart rhythm and rate
    NORMAL ECG READING

    NORMAL SINUS RHYTHM


    VENTRICULAR & ATRIAL RATE
    60 – 100 PER MINUTE
    RHYTHM – REGULAR
    QRS SHAPE NORMAL &
    DURATION < 0.12 SEC
    PR INTERVAL – 0.12 – 0.20 sec
    P:QRS RATIO - 1
    ECG TRACING
    ECG
    ECG
    Sinus tachycardia

    Rhythm :Regular
    Rate :Fast (> 100 bpm)
    P Wave :Normal may merge with T wave at very fast rates
    PR Interval :Normal (0.12-0.20 sec)
    QRS:Normal (0.06-0.10 sec)
    Notes :QT interval shortens with increasing heart rate
    Sinus bradycardia

    Rhythm :Regular
    Rate :Slow (< 60 bpm)
    P Wave :Normal
    PR Interval: Normal (0.12-0.20 sec)
    QRS:Normal (0.06-0.10 sec)
    Sinus arrhythmia

    Rhythm :Irregular, varying with respiration


    Rate :Normal (60-100 bpm) and rate may increase during
    inspiration
    P Wave :Normal
    PR Interval : Normal (0.12-0.20 sec)
    QRS:Normal (0.06-0.10 sec)
    Notes :Heart rate frequently increases with inspiration,
    decreasing with expiration
    FIRST DEGREE AV BLOCK

    • Atrial and ventricular rhythms regular


    • PR interval > 0.20 second
    • P wave precedes QRS complex
    • QRS complex normal
    • P : QRS ratio 1:1
    SECOND DEGREE BLOCK
    TYPE 1

    • Atrial rhythm regular


    • Ventricular rhythm irregular
    • PR interval progressively, but only slightly, longer with each
    cycle until QRS complex disappears (dropped beat); PR
    interval shorter after dropped beat
    P:QRS ratio 3:2, 4:3, 5:4
    SECOND DEGREE HEART
    BLOCK TYPE 2

    • Atrial rate regular


    • Ventricular rhythm regular or irregular, with varying degree of
    block
    • P-R interval constant
    • QRS complexes periodically absent
    • P:QRS RATIO 3:1, 4:1, 5:1 And so forth
    Third degree heart block

    Rhythm: Regular, but atrial and ventricular rhythms are independent


    Rate :Characterized by Atrial rate usually normal and faster than
    ventricular rate
    P Wave :Normal shape and size, may appear within QRS complexes
    PR Interval: Absent: the atria and ventricles beat independently.
    QRS:Normal, but wide if junctional escape focus
    ATRIAL FLUTTER
    Atrial flutter

    Rhythm :Regular or irregular


    Rate :Fast (250-350 bpm) for Atrial, but ventricular rate is often
    slower
    P Wave :Not observable, but saw-toothed flutter waves are
    present
    PR Interval :Not measureable
    QRS:Normal (0.06-0.10 sec)
    Atrial fibrillation

    Rhythm :Irregular
    Rate :Very fast (> 350 bpm) for Atrial, but ventricular rate
    may be slow, normal or fast
    P Wave :Absent - erratic waves are present
    PR Interval :Absent
    QRS:Normal but may be widened if there are conduction
    delay
    PVC

    Rhythm :Irregular
    Rate :The underlying rate
    P Wave :Absent
    PR Interval :Not measurable
    QRS:Wide (> 0.10 sec), bizarre appearance
    Notes Two PVCs together are termed a couplet while three
    PVCs in a row with a fast rhythm is ventricular tachycardia
    PVC QUADRIGEMINY

    Rhythm :Irregular
    Rate :The underlying rate
    P Wave :Absent
    PR Interval :Not measurable
    QRS:Wide (> 0.10 sec), bizarre appearance
    Notes :PVC appears every fourth beat
    PVC TRIGEMINY

    Rhythm :Irregular
    Rate :The underlying rate
    P Wave :Absent
    PR Interval :Not measurable
    QRS:Wide (> 0.10 sec), bizarre appearance
    Notes :PVC appears every third beat
    PVC BIGEMINY

    Rhythm :Irregular
    Rate :The underlying rate
    P Wave :Absent
    PR Interval :Not measurable
    QRS:Wide (> 0.10 sec), bizarre appearance
    Notes :PVC appears every second beat
    VENTRICULAR
    TACHYCARDIA

    Rate: Usually between 100-250 bpm


    P wave: obscured
    QRS: wide and bizarre
    Conduction: as with PVCs
    Rhythm: three or more ventricular beats in a row, may
    be regular or irregular
    May stop or start suddenly
    VENTRICULAR
    TACHYCARDIA
    Monomorphic

    Rhythm Regular
    Rate Fast (100-250 bpm)
    P Wave Absent
    PR Interval Not measurable
    QRSWide (>0.10 sec), bizarre looking
    VENTRICULAR
    TACHYCARDIA
    Polymorphic

    Rhythm :Regular or irregular


    Rate :Fast (100-300 bpm)
    P Wave :Absent
    PR Interval :Not measurable
    QRS:Normal or wide (>0.10 sec), bizarre looking
    VENTRICULAR
    TACHYCARDIA
    Torsade de pointes

    Rhythm :Irregular
    Rate :Fast (200-250 bpm)
    P Wave :Absent
    PR Interval :Not measurable
    QRSWide (>0.10 sec), bizarre looking
    VENTRICULAR FIBRILLATION

    Ventricular rhythm rapid and chaotic


    QRS complex wide and irregular, no
    visible P waves
    VENTRICULAR FIBRILLATION

    Rhythm :Highly irregular


    Rate :Unmeasurable
    P Wave :Absent
    PR Interval :Not measurable
    QRS:None
    Notes EKG tracings is a wavy line
    ASYSTOLE
    Dr. Manrique - Arreglo

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