ecg interpretation zai1

7/25/2019 Ecg Interpretation Zai1

1/95

HOW TO READ

ELECTROCARDIOGRAPHY

SMF Kardiologi dan Kedokteran Vak!lar

RS"D Tan#!ng P!ra

Langkat


2/95


3/95

STA$DARISASI EKG

Ke%e&atan kerta tandard EKG

25 mm / s (10 25 50 mm / s

Setia& kolo' (ori)ontal * +,+- e%

Setia& kolo' .ertikal /+ '' * / 'V


4/95


5/95


6/95

PEMASA$GA$ ELEKTRODE

PEMASANGAN ELEKTRODE EXTREMITAS Lengan kanan an !engan k"#"

Kak" kanan an kak" k"#"

PEMASANGAN ELEKTRODE DADA $1 % Pa#as&e#na! kanan " I'S)

$2 % Pa#as&e#na! k"#" " I'S)

$) % M'L k"#" " I'S5

$* % Me"an an&a#a $2 gn $)

$5 % Pa#a A+"!!a"# L"ne k"#" " I'S5

$, % Me"an A+"!!a"# k"#" " I'S5


7/95

SISTEMLEADS STANDARD LIM- LEADS

I. II. III

AGMENTED NIPOLAR LIM- LEADS a$R. a$L. a$

NIPOLAR 'EST LEADS $1. $2. $*. $). $5. $,

$*R. $)R. $5R. $,R

$. $3. $4

$R. $3R. $4R


8/95


9/95


10/95


11/95

V7 V8V9 V9RV8RV7R

Horizontal plane ofV4-6

"ni&olar Pre%odial 6C(et7 Lead

Mervin J. Goldman, MD. 11thedition Principles of clinical Electrocardiography. Clinical Professor of Medicine University ofCalifornia School of Medicine San Francisco @199!19"#


12/95


13/95


14/95

Conduction System

SA Node

Internodal branchAV NodeHiss BundlePurkinje FiberContraction


15/95


16/95

The Electrocardioram ! EC" #

$ P %a&e ' atrialde(olarisation

$ )*S com(le+ '&entricularde(olarisation

$T %a&e ' &entricularre(olarisation

$ Atrial re(olarisationhidden by )*S

P

)

*

S

T


17/95


18/95

ECG I$TERPRETATIO$

/, RHYTM

3, RATE

2, A8IS

-, HIPERTROPHIC SIG$S

1, MYOCARDIAL I$FARCTIO$0, ARRHYTHMIA


19/95

/,RHYTHM

$or'al %ardia% r(5t(' 9 SI$"S r(5t('

Sin! r(5t(' %(ara%teriti% 9Rate 0+:/++ ;&'Contant R < R inter.al$egati.e P =a.e in aVR and &oiti.e di IIP =a.e i al=a5 >ollo=ed ;5 ?RS %o'&le4


20/95

Normal Sinus Rhythm

*hythm ' *eular*ate ' ,- . /--P %a&e ' Normal in con0uration1 (recede each )*S

P* ' Normal ! -2 /3 . -23- seconds #)*S ' Normal ! less than -2/3 seconds #


21/95

ME$GHIT"$G DE$Y"T @A$T"$G 9


22/95


23/95

3, RATE

$or'al (eart rate 9 0+ < /++ 4'in!teB /++ 4'in!te 9 Sin! Ta%(5%ardia 0+ 4'in!te 9 Sin! radi%ardia

Deter'ination (eart rate 6nor'al &a&er &eed 31 ''79

2++

Co!nt n!';er o> large !are 6;old ;o4e in one R < R inter.al7

/1++

Co!nt n!';er o> 'all !are in one R < R inter.al

$!';er o> ?RS %o'&le4 in 0 e%ond '!lti&l5 ;5 /+


24/95


25/95

ME$E$T"KA$ A8IS EKG

Meng(it!ng A4i9 S& 6ang "7a& 8!e9 &"ngg"n6a : ;8!&age R " I

engan : &"ngg"n6a ;8!&age R " a$

A+"s 6g n8#ma! 7e#aa an&a#a *0< gn =40& A+"s De; 7e#aa an&a#a *0< gn 40< R"g9& A+"s De; 7e#aa an&a#a =40< gn =130"n"s"kan se7aga" ak9"# k8m@!eks RS an @e#m!aan segmen ST

ent!k eg'en ST 9

up-sloping( &"ak s@es">"k

horizontal( !e7"9 s@es">"k n&k "skem"a down-sloping( @a!"ng &e#@e#Fa6a n&k "skem"a

Per!;a(an gelo';ang T@aa

"skem"a k#ang 7eg"& s@es">"k

Ge!8m7ang T 9"@e#ak&

kaang2 me#@akan sa&sa&n6a

@e#7a9an EKG 6ang &e#!"9a&


42/95

Anato'i Koroner dan EKG /3 anda&an

Sana@an $1 an $2 meng9aa@ se@&a! a#ea ;en"ke! k"#"

Sana@an $* an $) meng9aa@ "n"ng an&e#"8# ;en"ke! k"#"

Sana@an $5 an $, ( "&am7a9 I an a;L meng9aa@

"n"ng !a&e#a! ;en"ke! k"#"

Sana@an II. III an a; meng9aa@ "n"ng "n>e#"8# ;en"ke! k"#"


43/95

1, MYOCARDIAL I$FARCTIO$

IsF9em"a

In#6

NeF#8s"s


44/95


45/95


46/95


47/95


48/95


49/95


50/95


51/95

A$TERIOR I$FARCTIO$


52/95

I$FERIOR I$FARCTIO$


53/95

POSTEROLATERAL I$FARCTIO$


54/95

A%!te anteroe&tal '5o%ardial in>ar%tion,

H5&era%!te T:=a.e %(ange are noted


55/95

A%!te anterolateral '5o%ardial in>ar%tion


56/95

A%!te in>ero&oterior '5o%ardial in>ar%tion


57/95

6 V H


58/95

6 V H


59/95

6 V H


60/95

6 V H

* V


61/95

* VH


62/95

* V H


63/95

* V H


64/95

ARRHYTHMIA


65/95

First-degree V !lo"#

*hythm ' *eular*ate ' 7sually normalP %a&e ' Sinus P %a&e (resent1 one P %a&e to each )P* ' Proloned ! reater than -23- seconds #

)*S ' Normal


66/95

AV LOCK

Se"ond -degree V !lo"# %o!itz &


67/95

Se"ond -degree V !lo"#$ %o!itz &

*hythm ' Irreular

*ate ' 7sually slo% but can be normalP %a&e ' Sinus P %a&e (resent1

some not 8ollo%ed by )*S com(le+esP* ' Proressi&ely lenthens)*S ' Normal


68/95

Se"ond-degree V !lo"#$ %o!itz &&


69/95

g

*hythm ' *eular usually1can be irreuler i8 conduction ratios &ary

*ate ' 7sually slo%P %a&e ' T%o9 three9 or 8our P %a&es be8ore each )*SP* ' P* inter&al o8 beat %ith )*S is constant1

P* inter&al may be normal or (roloned

)*S ' Normal i8 block in His bundle1%ide i8 block in&ol&es bundle branches

'hird-degree V !lo"#


70/95

g

*hythm ' *eular*ate ' :- . ,- i8 block in His bundle1

;- . :- i8 block in&ol&es bundle branchesP %a&e ' Sinus P %a&e (resent1 bear no relationshi( to )* can be 8ound hidden in )*S com(le+es and T %a&P* ' Varies reatly

)*S ' Normal i8 block in His bundle1%ide i8 block in&ol&es bundle branches


71/95


72/95


73/95


74/95


75/95


76/95


77/95


78/95


79/95


80/95


81/95

S@#a;en"F!a# &aF96Fa#"a


82/95

?"e F8m@!e+ &aF96Fa#"a


83/95

$en"F!a# >!&&e#


84/95


85/95


86/95


87/95


88/95


89/95


90/95


91/95


92/95


93/95


94/95


95/95

ecg interpretation zai1

Documents