1 / 36

Understanding ECG Basics and Reading Abnormalities

This lecture covers the fundamentals of Electrocardiography (ECG), including definitions, principles, and identification of common ECG abnormalities. It delves into the cardiac electrical system, the role of the Sinoatrial Node (the Pacemaker), and intracardiac electrical systems. The lecture also explains ECG denotations and interpretations, as well as the placement of electrodes for ECG recording. Students will learn how to estimate heart rate, recognize different rhythms like Sinus Tachycardia, Sinus Bradycardia, Atrial fibrillation, Atrial Flutter, and Paroxysmal Supraventricular Tachycardia, along with their common causes and treatments. Management of acute conditions like STEMI and NSTEMI are also discussed. By the end of the lecture, students should be proficient in understanding and interpreting basic ECGs.

maudec
Download Presentation

Understanding ECG Basics and Reading Abnormalities

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. BASIC ECG NITMED TUTORIALS INC

  2. GOALS OF THE LECTURE • At the end of this lecture, the students should be able to ; • Understand basic definitions and principle • Determine the heart rate • Identify common ECG abnormalities

  3. DEFINITIONS • Electrocardiography • Electrocardiogram • Electrogram • Electrocardiograph

  4. CARDIAC ELECTRICAL SYSTEM • Sinoatrial Node – the Pacemaker • Internodal fibres & intraatrial pathway • Atrioventricular node • Bundle of His • Bundle branches • Fascicles • Purkinje system

  5. The Pacemaker • The Sinoatrial Node is the Pacemaker. • First described in 1907 in the countryside of Kent (UK) by Arthur Keith and his laboratory assistance; Martin Flack (a young medical student). • As such it s also called Keith –Flack Node • SAN has P cells with special property: automaticity

  6. INTRACARDIAC ELECTRICAL SYSTEM

  7. Ionic Basis of Cardiac Electrical Impulses • Ionic movement across the cell membrane • Major ions ; Sodium, Potassium • Cycles of depolarisation and repolarisation

  8. THE ELECTROCARDIOGRAM PAPER

  9. ECG Denotations • P wave • QRS complex • T wave • PR interval • QT interval • RR interval • ST segment • J junction • U wave

  10. P wave – 0.12s • QRS wave – 0.1-0.12s • PR interval – 0.12-0.2s • QT interval : depends on age and sex • RR interval : 0.6-1s • T wave – 0.1-0.25s

  11. ELECTROCARDIOGRAPH(ECG MACHINE)

  12. ELECTRODES • 10 Electrodes ; 4 limb and 6 chest electrodes.

  13. Standard 12-Lead System • Standard bipolar limb leads: I,II & III • Augmented limb leads: aVF,aVL & aVR • Chest or precordial leads: V1-V6

  14. Chest Electrode Placement • V1-4th intercostal space, right sternal edge • V2-4th intercostal space, left sternal edge • V3-midway between V2 & V4 • V4-5th intercostal space, left midclavicular line • V5-5th intercostal space, left anterior axillary line • V6-5th intercostals space, left mid-axillary line

  15. Chest Electrodes

  16. Limb Electrodes

  17. Heart Rate Estimation Regular RR Interval HR = 300/x or 1500/y where x and y are no of big and small squares within RR interval respectively Irregular RR interval Use long rhythm strip method

  18. Sinus Tachycardia

  19. Sinus Tachycardia • Sinus rhythm • Heart rate > 100bpm • Common causes • Fever -Shock • Anaemia -Pulmonary Embolism • Pain -Shock • Hyperthyroidism -Sympathomimetics like adrenaline • Treatment: B blockers, Digoxin, CCB

  20. Sinus Bradycardia

  21. Sinus Bradycardia • Sinus rhythm • Heart rate < 60bpm • Common causes • Hypothermia -physical fitness • Hypothyroidism • Drugs like beta blockers • Vasovagal syncope • Treatment : atropine, isoprenalin, cardiac pacing

  22. Atrial fibrillation

  23. Atrial Fibrillation • No discrete P wave • Fibrillary waves • Irregular RR interval • Common causes: • Hyperthyroidism -Alcohol Abuse • Hypertension -Pulmonary embolism • Valvular Hear disease • Cardiomyopathy

  24. Atrial fibrillation • Treatment: B blockers, digoxin, CCBs, amiodarone, cadioversion, anticoagulant

  25. Atrial Flutter

  26. Atrial flutter • No discrete P waves • Saw tooth appearance • Causes are same as atrial fibrillation • Treatment : cardioversion, B blockers

  27. Paroxysmal Supraventricular Tachycardia

  28. Paroxysmal Supraventricular tachycardia • Narrow QRS complex • Occurs in paroxysms • Heart rate: 150-250bpm • P waves may not be seen • Treatment : Adenosine, esmolol, digoxin, cardioversion

  29. STEMI & NSTEMI

  30. STEMI • Initial treatment: Morphine Oxygen Nitroglycerine Aspirin • Definitive treatment: PCI and thrombolysis(streptokinase)

  31. NSTEMI • Initial Treatment: MONA • Definitive : B blockers, ace inhibitors, angiography and PCI

  32. Thank You

More Related