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ELECTROCARDIOGRAM (ECG)

ELECTROCARDIOGRAM (ECG). بسم الله الرحمن الرحيم. Cardiovascular System Physiology Lab Interpretation Dr.Mohammed Sharique Ahmed Quadri Asst. professor in physiology. Analyze the ECG and calculate the heart rate and cardiac axis. Know the importance of ST segment in IHD and MI.

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ELECTROCARDIOGRAM (ECG)

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  1. ELECTROCARDIOGRAM (ECG) بسم الله الرحمن الرحيم Cardiovascular System Physiology Lab Interpretation Dr.MohammedSharique Ahmed Quadri Asst. professor in physiology

  2. Analyze the ECG and calculate the heart rate and cardiac axis. • Know the importance of ST segment in IHD and MI. • Apply knowledge of analyzing ECG on interpretation of sinus tachycardia, sinus bradycardia, AF, IHD, MI, heart block. objective

  3. P wave : upright except in avR Normal duration: 0.08 to 0.11 sec do you see p waves ? are all p waves same ? does all QRS complexes have p waves ? • P-R interval : Normal range 0.12 – 0.20 sec Is the PR interval constant ? If prolong indicates various blocks Analyzing individual waves & segments

  4. QRS complexes: • Are the p waves & QRS complexes are associates with each other • Are the QRS complexes narrow or wide • ST Segment : • Normal : Isoelectric • Elevation : in acute MI • Depression : in ischemia • T wave: • Tall T wave : ischemia, hyperkalemia • Inverted : young children ,deep inspiration, bundle branch block, ischemia,hypokalemia Analyzing individual waves & segments

  5. QT INTERVAL: • 0.4 to 0.43 seconds depending upon heart rate. • At high heart rates, ventricular action potentials shorten in duration, which decreases the Q-T interval. • . prolonged in acute MI ,hypocalcaemia Analyzing individual waves & segments

  6. Variation in ST segment

  7. ST Elevation One way to diagnose an acute MI is to look for elevation of the ST segment.

  8. ST Elevation suggestive of MI

  9. ST Elevation (cont) Elevation of the ST segment (greater than 1 small box) in 2 leads is consistent with a myocardial infarction.

  10. Putting it all Together Do you think this person is having a myocardial infarction. If so, where? Yes, this person is having an acute anterior wall myocardial infarction.

  11. Now, where do you think this person is having a myocardial infarction? Inferior wall MI

  12. How about now? Anterior & lateral wall MI

  13. NORMAL HYPERKALEMIA HYPOKALEMIA

  14. INTERPRETE THE ECG ? HYPERKALEMIA Observe Tall T - wave

  15. This ecg shows • Sinus rhythm • Heart rate of 75/ min • Normal QRS axis • Normal PR interval 0.12 sec • Normal QRS duration 0.8 sec • ST segment isoelectric in all leads • T wave normal & upright in all wave except in aVR Reporting of ECG

  16. Text book of medical physiology by GUYTON & HALL 11 th edition Text book physiology by GANONG The ECG made Easy by John R.Hampton sixth edition The guide to EKGinterpretation by JohnA.Brose, D.O,John C.Auseon references

  17. Prof. Magdy El-Barbary

  18. Prof. Magdy El-Barbary Question NO: Suggestive of What is the most likely cause of changes in ST seg. & T wave of each diagram?

  19. ST elevation & depression T-waves peaked flattened inverted Appearance of pathologic Q-waves ECG Changes Ways the ECG can change include:

  20. Text book of medical physiology by GUYTON & HALL 11 th edition Text book physiology by GANONG The ECG made Easy by John R.Hampton sixth edition The guide to EKGinterpretation by JohnA.Brose, D.O,John C.Auseon References

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