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    ECG Study Guide

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    anna
    The 12-lead ECG measures the electrical activity of the heart over time through electrode placement on the body. Key intervals measured include the P wave, PR interval, QRS complex, QT interval, and axes. Abnormalities in these intervals can indicate conditions like myocardial infarction, arrhythmias, conduction blocks, and other cardiac issues. The ECG is useful for diagnosing conditions affecting heart rate, rhythm, and conduction.

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    ECG Study Guide

    Uploaded by

    anna
    80 views7 pages
    The 12-lead ECG measures the electrical activity of the heart over time through electrode placement on the body. Key intervals measured include the P wave, PR interval, QRS complex, QT interval, and axes. Abnormalities in these intervals can indicate conditions like myocardial infarction, arrhythmias, conduction blocks, and other cardiac issues. The ECG is useful for diagnosing conditions affecting heart rate, rhythm, and conduction.

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    ECG study guide

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    The 12-lead ECG measures the electrical activity of the heart over time through electrode placement on the body. Key intervals measured include the P wave, PR interval, QRS complex, QT interval, and axes. Abnormalities in these intervals can indicate conditions like myocardial infarction, arrhythmias, conduction blocks, and other cardiac issues. The ECG is useful for diagnosing conditions affecting heart rate, rhythm, and conduction.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    80 views7 pages

    ECG Study Guide

    Uploaded by

    anna
    The 12-lead ECG measures the electrical activity of the heart over time through electrode placement on the body. Key intervals measured include the P wave, PR interval, QRS complex, QT interval, and axes. Abnormalities in these intervals can indicate conditions like myocardial infarction, arrhythmias, conduction blocks, and other cardiac issues. The ECG is useful for diagnosing conditions affecting heart rate, rhythm, and conduction.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 7

    12 lead ECG

    - Electrode placement

    PQRST Significance

    - P wave: fist positive deflection <.12


    o Inferior (II, III), avf)
    - PR interval : onset of P wave to start QRS, conduction through the AV node .12-.2
    - QRS interval: <.12
    - QT interval: .42
    - QRS complex <.12
    o Ventricular depolarization
    o Q wave: 1st – deflection after P
    o R wave: 1st + deflection after P
    o R prime: 2nd positive deflection= BBB
    J point & ST segment
    - J point: QRS ends and ST begins
    o Even with isoelectric line
    - ST segment: completion of ventricular depolarization, prior to ventricular repolarization
    - TP segment: end of T wave to next P wve
    o Electrical silence in heart

    - QT interval: time it takes for ventricles to depolarize and repolarize


    o .36-.44
    o Longer when the HR is slower, shorter when the HR is faster
    o Bazzette formula: determines QTc or QT interval
    o Long= VT or VF

    Axis determination
    - QRS is most important to determine
    - Normal: -30 to +90, downward and to the left
    - Left axis deviation: -30 to -90
    o QRS is + in Lead I and – in lead aVF
    o Causes: inferior wall MI, LV hypertrophy, LBBB, ventricular ectopy
    - Right axis deviation: +90 to +180
    o QRS is – in Lead I and + in aVF
    o Causes: lateral wall MI, RBBB, right ventricular hypertrophy, dextrocardia, pulmomary
    embolism

    Bundle Branch Blocks


    - Problem with conduction system
    - QRS >.12
    - LBBB
    o Deep S in V1 V2 and broad R in V5, V6

    o
    o Causes: MI, CAD, aortic stenosis, cardiomyopathies, myocarditis, hyperkalemia, dig toxicity
    - RBBB
    o Large R wave in V1, V2, slurred S wave in V1, V5, V6
    o
    o Causes: 2/2 HTN, MI, myocarditis, COPD, cor pulmonae, RHF, pulmonary embolism

    Rhythm Patterns
    - NSR: 60-100
    o P before QRS followed by T wave
    - Sinus brady: <60
    o SSS, BB, hypothermia, hypoglycemia, hypothyroid, CAD
    - Sinus tachy : >100
    o Fever, anxiety, hyperthyroid, albuterol, dobutamine, anemia, pain

    Atrial Rhythms
    - Premature atrial contraction (PAC)
    o Ectopic focus within atria conduction to ventricles
    o Frequent= palpiatations

    o
    - Atrial Fibrillation
    o Irregularly irregular
    o Rapid firing within atria
    o No P waves, no PR interval
    o s/s= SOB, dizy, fatigue, chest pain

    o
    - Atrial Flutter
    o More organized
    o “sawtooth”

    o
    - Supraentricular tachycardia
    o Originates in AV node
    o Narrow complex tachycardia appearing rapid and regular

    Ventricular rhythms
    - Premature ventricular contraction (PVC)
    o Early impulse originating from ventricle
    o P wave is absent, QRS is wide and bizarre
    o MI, cardiomyopathy, electrolytes (hypokalemia), hypoxia

    o
    - Ventricular tachycardia
    o Abnormal electrical signals from ventricle
    o Loss of pulse and consciousness
    o ACLS

    o
    - Ventricular fibrillation
    o High frequency disorganization excitation of myocardium
    o No P wave or QRS, instead fibrillatory waves
    o Sudden cardiac death defib

    AV blocks
    - 1st degree AV block
    o rhythm with prolonged PR interval >.2
    o Well trained atheletes, inferior MI, hypokalemia
    o s/s: dizzy, dyspnea, fatigue

    o
    - 2nd AV block (Mobitz I or wenchebach)
    o Gradual increase in PR interval until blociked impulse and subsequent PR is shorter

    o
    nd
    - 2 degree AV block II (Mobitz II)
    o Constant PR interval leading to dropped QRS
    o Dixzzy, syncome, hypotension or brady
    o ? pacemaker

    o
    rd
    - 3 degree AV block (complete heart block)
    o No conduction through AV leading to AV dissociation
    o Regular P-P interval, regular R-R, failure of P and QRS
    o AMS, SOB, CP, syncope
    o Pacemaker

    Pacing
    - Oversensins: device does not initiate when it should
    - Undersensisng: fails to turn off
    - Capture: sufficient impulse
    - Atrial pacing: pacing prior to P wave

    o
    - Ventricular pacing: pacing prior to QRS

    o
    - AV pacing: pacing prior to P and prior to QRS
    o

    Digitalis toxicity
    - Parasoxysmal atrial tachycardia
    - Accelerated junctional rhythm
    - Bidirectional ventricular tachycardia
    - AV blocks

    Hypothermia
    - Bradyarrythmias
    - Prolonged PR, QRS, QT
    - Osborn and J waves

    -
    Pericarditis
    - Stage I: Diffuse, concave upward ST segment elevation in most leads and subtle or overt PR depression
    - Stage II: ST segment elevation and PR depression return to baseline; may have normal or flattened T
    waves
    - Stage III: T waves are inverted; the ECG is otherwise normal
    - Stage IV: ECG returns back to normal

    Pulmonary Embolism
    - Tachycardia
    - S1Q3T3 pattern
    - Classic findings of right heart strain
    o Tall, peaked p waves in Lead II
    o Right axis deviation
    o Right bundle branch block

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