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ECG

ECG. Dr. Mohammed Shaat Modified by : Dr. Amal Al Maqadma. Electrocardiography. It is a voltage difference, record the electrical activity of the heart as well as valuable information about the heart function and structure. Willem Einthoven 1924. Leads ( lead x electrode ). LIMB LEADS

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ECG

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  1. ECG Dr. Mohammed Shaat Modified by : Dr. Amal Al Maqadma.

  2. Electrocardiography It is a voltage difference, record the electrical activity of the heart as well as valuable information about the heart function and structure. Willem Einthoven 1924

  3. Leads (lead x electrode) • LIMB LEADS I II III AVF AVL AVR • CHEST LEADS V1 V2 V3 V4 V5 V6 bipolar unipolar

  4. Limb leads

  5. Limb leads

  6. Both limb leads

  7. Chest leads

  8. What chest lead represent ?

  9. ECG Leads - Views of the Heart • V1 & V2 Septum • V3 & V4 anterior +Right Ventricle • V5 & V6 Lateral Left Ventricle • II+III+AVF inferior border

  10. : einthoven's triangle

  11. ECG Paper ECG Speed 25mm/sec

  12. 12 lead ECG layout:

  13. See video

  14. ECG Cardiac Cycle

  15. What is the isoelectric line؟

  16. P wave • Represent the electrical activity of both atria ( atrial depolarization) • The depolarization slow within the AV node, there is a brief delay or PAUSE before the depolarization conducted to the ventricles

  17. Normal duration <0.12 secAbsent P wave:Atrial fibrillation SA BlockAV RhythmPeak P wave:Atrial hypertrophy

  18. PR interval • Normally :0.12-0.2sec • Prolonged in : heart block. • Short in : W-P-W syndrome.

  19. QRS Complex • Represent the electrical activity of both ventricles. • Ventricular depolarization( initiation of the ventricular contraction

  20. QRS Complex • Q wave • Rwave: • S wave : • : Normal QRS duration < 0.12 sec

  21. QRS Complex • Q wave • first downward deflection . • septal depolarization. • 0.04sec.

  22. Rwave: first upwarddeflection. height: 5-8 mm. early ventricular depolarization

  23. S wave : late ventricular depolarization,

  24. Large QRS indicate Ventricular hypertrophy.

  25. ST - Segment • ST segment: the plateau phase of ventricular repolarization. • Isoelectric or> or<1mm. • If the ST segment elevated or depressed beyond the normal baseline this usually sign of serious pathology. (MI)

  26. T- Wave • T-wave :represent rapid phase of ventricular repolarization. peaked Twave: • early MI • hyperkalemia • Black races Inverted : • MI . • Ventricular hypertrophy. • Hypokalemia • Digoxin

  27. Q-T interval • 0.4sec in HR 70 • Prolonged in : • Hypocalcemia • hypomagnesemia

  28. U wave • repolarization of the interventricular septum. • low amplitude • Prominent: suspect hypokalemia, hypercalcemia or hyperthyroidism

  29. J wave • represents the approximate end of depolarization and the beginning of repolarization • camel-hump sign . • Hypothermia • hypocalcemia.

  30. Low voltage ECG • Obesity • Emphysema • COPD • Severe hypothyroidism

  31. Rate • Normal heart rate 60-100/ min • < 60 called bradycardia • >100 called tachycardia

  32. How To Calculate Heart Rate ?

  33. 300 HR= No. of Large box btw R-R 1500 HR= No. of Small box btw R-R

  34. RHYTHM • Look For The Distance between Identical waves. • Most commonly used R-R

  35. AXIS At any point during depolarization and repolarization electrical potential are being propagated in different directions. Most of these cancel each other out and only the net force is recorded. This net is called AXIS or cardiac VECTOR

  36. How To Check Axis in ECG

  37. THANKS

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