Library of Congress Cataloging-in- Publication Data. ECG interpretation made incredibly easy!. —. 5th ed. p. ; cm. Includes bibliographical references and index . Interpreting the ECG. •Rate. •Rhythm. - Ectopic beats? •Axis. •Intervals. - Blocks? •Atrial Abnormalities. •Ventricular hypertrophy. •ST/T changes. P wave = atrial depolarisation. PR Interval = impulse from atria to ventricles to ventricles. QRS complex = ventricular depolarisation. ST segment = isoelectric -.
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To get the most out of the Basic ECG Interpretation Study Day please read this Package prior to Welcome to the (a)ECG Interpretation learning package. Interpreting EKG Rhythm Strips. Step 1 – Heart Rate. Methods to determine heart rate. ▫ The 6 second method. ▫ Denotes a 6 second interval on EKG strip. Discuss a systematic approach to rhythm interpretation. Review common cardiac arrhythmias. Describe the process for interpretation of a 12 lead ECG.
In contrast, that same depolarization would produce minimal deflection in V1 and V2 because the vectors are perpendicular and this phenomenon is called isoelectric. Normal rhythm produces four entities — a P wave, a QRS complex, a T wave, and a U wave — that each have a fairly unique pattern.
The P wave represents atrial depolarization. The QRS complex represents ventricular depolarization. The T wave represents ventricular repolarization. The U wave represents papillary muscle repolarization. However, the U wave is not typically seen and its absence is generally ignored. Changes in the structure of the heart and its surroundings including blood composition change the patterns of these four entities.
Background grid[ edit ] ECGs are normally printed on a grid.
The horizontal axis represents time and the vertical axis represents voltage. The "large" box is represented by a heavier line weight than the small boxes. Not all aspects of an ECG rely on precise recordings or having a known scaling of amplitude or time. For example, determining if the tracing is a sinus rhythm only requires feature recognition and matching, and not measurement of amplitudes or times i.
An example to the contrary, the voltage requirements of left ventricular hypertrophy require knowing the grid scale.
Rate and rhythm[ edit ] In a normal heart, the heart rate is the rate in which the sinoatrial node depolarizes as it is the source of depolarization of the heart.
Heart rate, like other vital signs like blood pressure and respiratory rate, change with age. In adults, a normal heart rate is between 60 and bpm normocardic where in children it is higher. A complication of this is when the atria and ventricles are not in synchrony and the "heart rate" must be specified as atrial or ventricular e. In normal resting hearts, the physiologic rhythm of the heart is normal sinus rhythm NSR. Generally, deviation from normal sinus rhythm is considered a cardiac arrhythmia.
Thus, the first question in interpreting an ECG is whether or not there is a sinus rhythm. Once sinus rhythm is established, or not, the second question is the rate. For a sinus rhythm this is either the rate of P waves or QRS complexes since they are 1-to The reader will gradually notice that ECG interpretation is markedly facilitated by using an algorithm, as it minimizes the risk of missing important abnormalities and also speeds up the interpretation.
What degree AV block. Note that narrow complex tachyarrhythmia rarely causes circulatory compromise or collapse.
PR interval hump in lead II and enhanced negative deflection in V1. An escape rhythm arises cardiac arrest ensues otherwise , which may have narrow or wide QRS complexes, depending on its origin.
There is no relation between P-waves and the escape rhythm's QRS complexes, and atrial rhythm is typically faster than the escape rhythm both rhythms are typically regular. Right bundle branch block. Class limb lead with R-wave amplitude I antiarrhythmic drugs. Tricyclic antidepressants. Aberrant conduction abberancy.
Pre-excitation there is low voltage. Wolff-Parkinson-White syndrome. Normal variant in younger, well-trained and slender mm. Misplaced leads.
Chronic obstructive pulmonary disease. Hypothyreosis typically accompanied by amplitude in same lead, in at least bradycardia. Extensive myocardial infarction. Pericardial effusion. Pleural effusion. Left-sided the chest leads V1—V6 normal? Bundle branch blocks.
Anterior www. Ventricular hypertrophy. Electrical axis is assessed in limb Acute cor pulmonale.
Right ventricular hypertrophy reversed R-wave progression. Left ventricular hypertrophy amplified R-wave progression. Chronic cor pulmonale. Left bundle branch block.
Normal variant. Situs inversus. Right ventricular hypertrophy. Hypertrophic cardiomyopathy. Acute cor pulmonale pulmonary embolism.
Chronic cor pulmonale COPD, pulmonary hypertension, pulmonary valve stenosis. Lateral ventricular infarction.