basic ecg
DESCRIPTION
ECG is very important tool in diagnosis of various cardiovascular diseases ,it is important for every one dealing with cardiac patients to be aware about the basic information of electocardiogram, so my 1st lecture focused on conductiong system of the heart , the generation of deflection in ECG , and normal morphology of its waveform, and lastly focus oh method to determine heart rate and cadiac axis .TRANSCRIPT
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Basic ECGEducational Programmes
By
Dr. Abdelsalam SherifMD Cardiology
August 13, 2014RNH( 1st Lecture)
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QUICK REVIEW OF HEART
Purpose • Pumps blood Basic Anatomy• 4 chambers• 2 sides • 4 valves
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THE CONDUCTING SYSTEM
• SA Node• Inter-nodal
pathway• AV Node• Bundle of HIS• Bundle Branches• Purkinje Fibers
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RELATIONSHIP
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Relationship
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Hold It!
SA NodeNormal Pacemaker
Activation Of The Heart
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PQ ST
P QRS
T
PR interval
QT interval
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Time
0.04 sec
1 sec
0.2 sec
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Time
Volta
ge0.2
seconds
1 m
illiV
olt
0.1 mV
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Cardiac Cycles
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HOOKING UP THE 12-LEAD ECG
• Proper skin prep
• Placement of the limb electrodes
• Placement of the chest electrodes
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ELECTRODE PLACEMENT
• LIMB LEADS
• CHEST LEADS
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LIMB LEADS
• Bipolar leads I, II, III
• Augment leads AVR, AVl, AVF
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RULING OUT LIMB LEAD REVERSAL
• AVR is always negative
• Lead I is always positive
• Lead II and III positive for the P wave and usually the QRS complex
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Chest Leads
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CHEST LEADS
6 UNIPOLAR LEADS
• V1• V2 • V3• V4 • V5• V6
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CHEST LEADS CHEST LEADS
COLUMN III• R wave progression • Small to Tall
COLUMN IV• R wave progression • Tall to Small
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Some Problems With The ECG
• Artifact• Electrical interference• Somatic tremor• Wandering baseline
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ARTIFACT ON THE ECG
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THE ARTEFACT
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BASELINE WANDERING
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SOMATIC TREMOR
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ELECTRICAL INTERFERANCE
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Method" of ECG Interpretation
1. Measurements.2. Rhythm Analysis.3. Conduction Analysis.4. Waveform description.5. ECG interpretation.6. Comparison with previous ECG ( if any ).
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Determination OF Heart Rate
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1st Method
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2nd Method
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2nd Method
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Determination Of QRS axis
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EINTHOVENS TRIANGLE
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QRS Axis Determination
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Axis in Normal range
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Left Axis Deviation
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Right Axis Deviation
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Thanks