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HOW TO READ ELECTROCARDIOGRAPHY

HOW TO READ ELECTROCARDIOGRAPHY. SYARIF HIDAYATULLAH STATE ISLAMIC UNIVERSITY (UIN), JAKARTA. Dr. Yasmin Tadjoedin , Sp.JP. ECG INTERPRETATION. RATE RHYTHM AXIS HIPERTROPHIC SIGNS MYOCARDIAL INFARCTION ARRHYTHMIA. Rhytm QRS Rate QRS Axis P wave PR Interval QRS Duration

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HOW TO READ ELECTROCARDIOGRAPHY

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  1. HOW TO READ ELECTROCARDIOGRAPHY SYARIF HIDAYATULLAH STATE ISLAMIC UNIVERSITY (UIN), JAKARTA Dr. YasminTadjoedin, Sp.JP

  2. ECG INTERPRETATION • RATE • RHYTHM • AXIS • HIPERTROPHIC SIGNS • MYOCARDIAL INFARCTION • ARRHYTHMIA

  3. Rhytm QRS Rate QRS Axis P wave PR Interval QRS Duration QRS Morphology ST Segmen Deviation T wave morphology U wave Others (LVH,LV Strain,BBB, QT interval) ECG conclusion STEPS IN ECG READING : NORMAL VALUES : PR Interval 0,12’’ - 0,20’’ QRS Duration 0,04’’ - 0,12’’ Normal Axis - 300 - + 1100

  4. 1. RATE • Normal heart rate : 60 – 100 x/minutes • > 100 x/minutes : Sinus Tachycardia • < 60 x/minutes : Sinus Bradicardia • Determination heart rate (normal paper speed 25 mm/s): • 300 • Count number of large square (bold boxes in one R – R’ interval) • 1500 • Count number of small square in one R – R’ intervals • Number of QRS complex in 6 seconds, multiply by 10

  5. 2. RHYTHM Normal cardiac rhythm : SINUS rhythm • Sinus rhythm characteristics : • Rate 60-100 bpm • Constant R – R interval • Negative P wave in aVR and positive di II • P wave is always followed by QRS complex

  6. 3. AXIS

  7. 4. HYPERTROPHIC SIGNS LEAD II

  8. LEAD V1

  9. 5. MYOCARDIAL INFARCTION • Ischemia • Injury • Necrosis

  10. ANTERIOR INFARCTION

  11. INFERIOR INFARCTION

  12. POSTEROLATERAL INFARCTION

  13. ARRHYTHMIA

  14. AV BLOCK

  15. Complete heart block

  16. COMPLETE LEFT BUNDLE BRANCH BLOCK (LBBB)

  17. COMPLETE RIGHT BUNDLE BRANCH BLOCK (RBBB)

  18. WHAT’S WRONG?? Lead Error: V1 and V3 are Transposed! In this normal 12-lead ECG the V1 and V3 chest electrodes are interchanged. Experienced ECG interpreters should be able to spot this lead placement error.

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