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    ECG Abnormalities - A Collection of Things To

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    Remegio Casidsid
    This document discusses various ECG abnormalities and what they may indicate. It emphasizes that an overall clinical picture should be obtained and not making assumptions based on one aspect or lead. Specifically it covers: - P waves indicating atrial enlargement - Q waves representing dead myocardial tissue or normal septal depolarization - Small or large QRS complexes and what they may indicate - Widened QRS from various causes like hyperkalemia or drugs - ORS notching associated with early repolarization or pericarditis - ST changes indicating ischemia or injury - Abnormal T waves and what features like size, shape, or direction may signify.

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    ECG Abnormalities - A Collection of Things To

    Uploaded by

    Remegio Casidsid
    32 views11 pages
    This document discusses various ECG abnormalities and what they may indicate. It emphasizes that an overall clinical picture should be obtained and not making assumptions based on one aspect or lead. Specifically it covers: - P waves indicating atrial enlargement - Q waves representing dead myocardial tissue or normal septal depolarization - Small or large QRS complexes and what they may indicate - Widened QRS from various causes like hyperkalemia or drugs - ORS notching associated with early repolarization or pericarditis - ST changes indicating ischemia or injury - Abnormal T waves and what features like size, shape, or direction may signify.

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    ECG Abnormalities- A Collection of Things To

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    This document discusses various ECG abnormalities and what they may indicate. It emphasizes that an overall clinical picture should be obtained and not making assumptions based on one aspect or lead. Specifically it covers: - P waves indicating atrial enlargement - Q waves representing dead myocardial tissue or normal septal depolarization - Small or large QRS complexes and what they may indicate - Widened QRS from various causes like hyperkalemia or drugs - ORS notching associated with early repolarization or pericarditis - ST changes indicating ischemia or injury - Abnormal T waves and what features like size, shape, or direction may signify.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    32 views11 pages

    ECG Abnormalities - A Collection of Things To

    Uploaded by

    Remegio Casidsid
    This document discusses various ECG abnormalities and what they may indicate. It emphasizes that an overall clinical picture should be obtained and not making assumptions based on one aspect or lead. Specifically it covers: - P waves indicating atrial enlargement - Q waves representing dead myocardial tissue or normal septal depolarization - Small or large QRS complexes and what they may indicate - Widened QRS from various causes like hyperkalemia or drugs - ORS notching associated with early repolarization or pericarditis - ST changes indicating ischemia or injury - Abnormal T waves and what features like size, shape, or direction may signify.

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    Download as PPT, PDF, TXT or read online from Scribd
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    ECG abnormalities- a collection of things to think about!

    P wave

    Inverted = retrograde conduction Will be negative in aVR

    Peaked

    P waves are a classic finding in severe right atrial enlargement if they are over 2.5mm high. Biphasic or M shaped P waves usually indicate atrial or biatrial enlargement
    Remember to obtain an overall clinical picture. Do not make assumptions based on one aspect or lead on a ECG

    Q waves

    Main interpretations of a significant Q wave is that it represents dead myocardial tissue Insignificant Q waves are merely a representation of the first vector of ventricular depolaristion- these are referred to as septal Q waves and are usually found in leads I and aVL Significant Q waves (pathological): More than1/3 the total height of the QRS Wider than 0.03 seconds
    (it is better to have both criteria but the second one is more significant) Remember to obtain an overall clinical picture. Do not make assumptions based on one aspect or lead on a ECG

    QRS complex

    Small amplitude may indicate:

    Pericardial effusion Increased body fat Localised pleural effusion (may dampen certain leads)

    Remember to obtain an overall clinical picture. Do not make assumptions based on one aspect or lead on a ECG

    QRS complex

    Large amplitude:

    Men have a larger amplitude than woman Younger persons have amplitude QRS size usually caused by hypertrophy, abnormal pacer or abberantly conducted beat Pericardial effusion Increased body fat Localised pleural effusion (may dampen certain leads)
    Remember to obtain an overall clinical picture. Do not make assumptions based on one aspect or lead on a ECG

    Widened QRS complex


    Hyperkalemia Ventricular Tachycardia Idioventricular rhythms including AVNB Drug effects and ODs especially tricyclics Wolff-Parkinson- White BBB and IVCD PVBs Aberrantly conducted beats
    Remember to obtain an overall clinical picture. Do not make assumptions based on one aspect or lead on a ECG

    ORS notching

    May cause benign ST elevation but you can almost be sure that when you see the notching that the ST elevation afterward is benign. Do not confuse with a J or Osborne wave. Almost always associated with early reploarisation pattern or pericarditis.
    Remember to obtain an overall clinical picture. Do not make assumptions based on one aspect or lead on a ECG

    ST segment

    In general, ST depression and T waves in the opposite direction from what is normal are a sign of ischemia ST elevation with or without T wave changes is a sign of myocardial injury

    Remember to obtain an overall clinical picture. Do not make assumptions based on one aspect or lead on a ECG

    T wave

    All symmetrical T waves should be considered pathological until proven otherwise Biphasic T waves can occur in any lead but especially the leads transitioning between a positive and a negative lead If the first part of the T wave is negative the cause is more likely to be pathological

    Remember to obtain an overall clinical picture. Do not make assumptions based on one aspect or lead on a ECG

    T wave

    If the T wave is more than 2/3 the height of the R wave it is definitely abnormal. Tall T waves are associated with ischemia and infarction, CNS events and potassium levels If the T waves is negative, where it should be positive, such as lead II, it is flipped. Flipped T waves are sometimes indicative of ischemia and severe ventricular hypertrophy etc

    Remember to obtain an overall clinical picture. Do not make assumptions based on one aspect or lead on a ECG

    T wave

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