the basic of ecg

Download The Basic of Ecg

Post on 16-Jan-2016

16 views

Category:

Documents

1 download

Embed Size (px)

DESCRIPTION

ekg

TRANSCRIPT

  • Wisnoe Pribadi SpJP

  • Conduction SystemSA Node Internodal branch AV Node Hiss Bundle Purkinje Fiber Contraction

  • The Electrocardiogram ( ECG )P wave : atrial depolarisation

    QRS complex : ventricular depolarisation

    T wave : ventricular repolarisation

    Atrial repolarisation hidden by QRSPQRST

  • v9

  • P Wave

  • P Pulmonale

  • P Mitrale

  • PR Interval

  • QRS Complex

  • ST Segment

  • T Wave

  • INTERPRETATION ECGP wavePR intervalQ waveR waveS waveST segmentT wave

  • Normal Sinus Rhythm

    Rhythm : RegularRate : 60 100P wave : Normal in configuration; precede each QRSPR : Normal ( 0. 12 0.20 seconds )QRS : Normal ( less than 0.12 seconds ) SINUS ARRYTMIA SINUS BRADYCARDIASINUS TACHYCARDIA

  • First-degree AV block

    Rhythm : RegularRate : Usually normalP wave : Sinus P wave present; one P wave to each QRSPR : Prolonged ( greater than 0.20 seconds )QRS : Normal

  • Second -degree AV block, Mobitz I

    Rhythm : IrregularRate : Usually slow but can be normalP wave : Sinus P wave present; some not followed by QRS complexesPR : Progressively lengthensQRS : Normal

  • Second-degree AV block, Mobitz II

    Rhythm : Regular usually; can be irreguler if conduction ratios varyRate : Usually slowP wave : Two, three, or four P waves before each QRSPR : PR interval of beat with QRS is constant; PR interval may be normal or prolongedQRS : Normal if block in His bundle; wide if block involves bundle branches

  • Third-degree AV block

    Rhythm : RegularRate : 40 60 if block in His bundle; 30 40 if block involves bundle branchesP wave : Sinus P wave present; bear no relationship to QRS; can be found hidden in QRS complexes and T wavesPR : Varies greatlyQRS : Normal if block in His bundle; wide if block involves bundle branches

  • Wolff-Parkinson-White syndrome

  • ST depresi dan perubahan gelombang T

    ST depresi dianggap bermakna bila > 1 mm di bawah garis dasar PT di titik J Titik J didefinisikan sebagai akhir kompleks QRS dan permulaan segmen ST

    Bentuk segmen ST :

    up-sloping ( tidak spesifik ) horizontal ( lebih spesifik untuk iskemia ) down-sloping ( paling terpercaya untuk iskemia )Perubahan gelombang T pada iskemia kurang begitu spesifik Gelombang T hiperakut kadang2 merupakan satu-satunyaperubahan EKG yang terlihat

  • HYPERACUTE T WAVE

  • ST DEPRESSIONHORIZONTALDOWN SLOOPINGUP SLOOPING

  • Anatomi Koroner dan EKG 12 sandapan ( LEAD )

    Sandapan V1 dan V2 menghadap septal area ventrikel kiri

    Sandapan V3 dan V4 menghadap dinding anterior ventrikel kiri

    Sandapan V5 dan V6 ( ditambah I dan avL ) menghadap dinding lateral ventrikel kiri

    Sandapan II, III dan avF menghadap dinding inferior ventrikel kiri

  • Unstable angina

  • Acute anteroseptal myocardial infarction. Hyperacute T-wave changes are noted

  • Acute anterolateral myocardial infarction

  • High lateral infarction

  • Inferior myocardial infarction

  • Acute inferoposterior myocardial infarction

  • L V H

  • L V H

  • L V H

  • R V H

  • R V H

  • R V H

Recommended

View more >