Basic Ecg Reading - Mcu
Basic Ecg Reading - Mcu
Basic Ecg Reading - Mcu
The EKG is not only the oldest but, in fact, over 100 years
after its introduction, continues as the most commonly used
cardiovascular laboratory procedure.
What is an ECG?
Is a graphic recording of electric potentials
generated by the heart.
Immediately available, non invasive, inexpensive
and highly versatile test
It is use to detect arrythmias, conduction
disturbances, myocardial ischemia, other related
life threatening metabolic disturbances.
Normal Impulse Conduction
Sinoatrial node
AV node
Bundle of His
Bundle Branches
Purkinje fibers
Impulse conduction and ECG
Sinoatrial node
AV node
Bundle of His
Bundle Branches
Purkinje fibers
Limb Leads
Precordial Chest Leads
Precordial Leads
Anatomic Groups
(Septum)
Anatomic Groups
(Anterior Wall)
Anatomic Groups
(Lateral Wall)
Anatomic Groups
(Inferior Wall)
Anatomic Groups
(Summary)
The ECG Paper
Horizontallybox - 0.04
One small s
One large box - 0.20 s
Vertically
One large box - 0.5 mV
ECG paper
3 sec 3 sec
P wave - Atrial
depolarization
QRS - Ventricular
depolarization
T wave - Ventricular
repolarization
ECG waveforms and Intervals
ECG waveforms and Intervals
PR interval
beginning of P wave to the beginning of the next QRS
Normally, < .2 seconds or one large box.
If it is > .2 seconds, it is a first degree block
ECG waveforms and Intervals
QRS interval
beginning of Q to the end of the S wave)
should be < .12 seconds (< 3 small boxes)
If QRS is > .12, check for bundle branch block.
ECG waveforms and Intervals
QT interval
beginning of QRS to end of T wave
should be less than half of the preceding RR interval -
this varies with the rate
For normal rates, QT < .4 seconds (2 large boxes).
ECG Interpretation
Rate / Rhythm
Axis
Atrial Abnormality or Hypertrophy
Heart Blocks
Ischemia or Infarction
Ventricular Hypertrophy
Misc.
(Non specific ST wave changes,Persistent
posterobasal forces)
I. RATE AND RHYTHM
3 sec 3 sec
Option 1
OPTION #1
Count the # of R waves in a 6 second rhythm strip,
then multiply by 10.
INTERPRETATION?
9 x 10 = 90 bpm
Step 1. Calculate Rate
R wave
Option 2
Find a R wave that lands on a bold line.
Count the # of large boxes to the next R wave. If the
second R wave is 1 large box away the rate is 300, 2
boxes - 150, 3 boxes - 100, 4 boxes - 75, etc. (cont)
Step 1: Calculate Rate
3 1 1
0 5 0 7 6 5
0 0 0 5 0 0
Option 2 (cont)
Memorize the sequence:
300 - 150 - 100 - 75 - 60 - 50
R R R R
Irregular RR interval
No discernible P waves
Premature Ventricular
Contractions