2 Februari 2018 EKG
2 Februari 2018 EKG
2 Februari 2018 EKG
BASICS OF EKG
INTERPRETATION 1
Rhythm 2
Lead EKG5
Rate 11
-Rule of 300
Take the number of “big boxes” between neighboring QRS
complexes, and divide this into 300. The result will be
approximately equal to the rate. Although fast, this method only
works for regular rhythms.12
* 300 dibagi jumlah kotak besar antara kompleks QRS = Rate
Systematic Approach30
-Rate (pake 2 cara tadi rule of 300 atau 10 second rule)
-Rhythm
-Sinus
-Atrial
-Junctional
-Ventricular
-Axis
-Wave Morphology
-P, T, and U waves and QRS complex
-Intervals
-PR, QRS, QT
-ST Segment
Sinus Rhythms: Criteria/Types32
-P waves upright in I, II, aVF
-Constant P-P/R-R interval
-Rate
-Narrow QRS complex
-P:QRS ratio 1:1
-P-R interval is normal and constant
-Sinus Bradycardia
Rate Summary 57
-Sinus Tachycardia (100-160 BPM)
-Atrial Tachycardia (150-250 BPM)
-Atrial Flutter (150-250 BPM)
-Junctional Tachycardia (100-180 BPM)
AV Nodal Blocks 58
-Delay conduction of impulses from sinus node
-If AV node does not let impulse through, no QRS complex is
seen
-AV nodal block classes: 1st, 2nd, 3rd degree
-1st Degree AV Block
Another Consideration:
-Wolfe-Parkinson-White (WPW)
*Caused by bypass tract, AV node is
bypassed, delay, EKG shows short PR
interval <.11 sec, Upsloping to QRS
complex (delta wave). 63
Ventricular Arrhythmias:65
-Criteria
-Wide QRS complex
-Rate : variable
-No P waves
-Types
-Premature Ventricular Contractions
Chamber Enlargements
-Left Ventricular Hypertrophy (LVH)
-Differential Diagnosis 74
A)Hypertension (HTN)
B)Aortis Stenosis (AS)
C)Aortic Insufficiency (AI)
D)Hypertrophic Cardiomyopathy (HCM)
E)Mitral Regurgitation (MR)
F)Coarctation of the Aorta (COA)
G)Physiologic
-False positivem75
A)Thin chest wall
B)Status post mastectomy
C)Race, Sex, Age
D)Left Bundle Branch Block (LBBB)
E)Acute MI
F)Left Anterior Fascicular Block
G)Incorrect standardization
Limb leads
-R in L + S in V3 >25 in men,
and >20 in women. 16% 97%
(Cornell Voltage)
-R in I + S in III > 25 10.6% 100%
-R in L > 11 man, 9 wom 10.6% 100%
-R in avF > 20 1.3% 99.5%
-S in avR > 14
LVH with Strain78
-Causes 81
-Chronic Obstructive Pulmonary Disease
-Pulmonary HTN (Primary)
-Pulmonary Embolus
-Mitral Stenosis
-Mitral Regurgitation
-Chronic LV failure
-Tricuspid Regurgitation
-Atrial Septal Defect
-Pulmonary Stenosis
-Tetralogy of Fallot
-Ventricular Septal Defect
- Lead V1 87
-Right
-Complete
-Incomplete
*Complete (QRS > .12 secs) , Incomplete (QRS .10 - .12 secs)
-Ischemia104
-Pericarditis130
- T Waves 133
#Summary134
-Basic physiology of the conduction system
-Origin of a normal EKG
-Systematic approach to reading an EKG
-Major abnormalities when reading an EKG