Basic ecg interpretation pdf

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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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Basic Ecg Interpretation Pdf

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.

Received Jun 27; Accepted Sep Abstract The use of dynamic electrocardiogram ECG monitoring is regarded as a standard of care during general anesthesia and is strongly encouraged when providing deep sedation. Although significant cardiovascular changes rarely if ever can be attributed to mild or moderate sedation techniques, the American Dental Association recommends ECG monitoring for patients with significant cardiovascular disease. The purpose of this continuing education article is to review basic principals of ECG monitoring and interpretation. Keywords: Electrocardiography, Patient monitoring, Continuing education Dynamic electrocardiographic ECG monitoring is a standard of practice when providing general anesthesia, but opinions are mixed regarding its use during moderate conscious and deep sedation. The American Dental Society of Anesthesiology included pulse oximetry for patient monitoring in its guidelines published in The American Dental Association recently revised its monitoring guidelines to include ECG monitoring for all deeply-sedated patients and for consciously-sedated patients with compromised cardiovascular function. Despite this controversy, a growing number of state dental boards are requiring ECG monitoring for general anesthesia and all levels of intravenous sedation. Disregarding these legal controversies, there is an intangible reassurance provided by an ECG monitor that adds to that provided by periodic measurement of blood pressure and continuous pulse oximetry. This of course presumes that the operator is comfortable witnessing occasional benign arrhythmias and the subtle mechanical nuances all monitors present during routine use. The purpose of this Continuing Education article is to provide fundamental concepts of ECG recognition that will enable the dentist to feel more comfortable with the routine use of dynamic ECG monitoring. General Principles of Cardiac Function The output of the heart per minute cardiac output is the paramount cardiovascular event required to sustain blood flow throughout the body.

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.

How to read an Electrocardiogram (ECG). Part One: Basic principles of the ECG. The normal ECG

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.

Fundamentals of Electrocardiography Interpretation

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.

Download the Pocket Guide to ECG Interpretation (PDF)

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.

ECG Interpretation | Wiley Online Books

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.

Pre- excitation.