1 / 65

Baby Steps to ECG

Baby Steps to ECG. Dr Saqib Mahmud MRCP(UK), MRCPS(Glasg) , MRCGP. Electrical Conducting system . ECG LEADS. leads representing regions. Anatomic region of heart & associated coronary artery. Inferior MI ----------------RCA Antero-septal MI---------LAD

bernad
Télécharger la présentation

Baby Steps to ECG

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Baby Steps to ECG Dr Saqib Mahmud MRCP(UK), MRCPS(Glasg), MRCGP

  2. Electrical Conducting system

  3. ECG LEADS

  4. leads representing regions

  5. Anatomic region of heart & associated coronary artery • Inferior MI----------------RCA • Antero-septal MI---------LAD • Antero-lateral MI---------Circumflex • Posterior MI--------------RCA ----------------------------------------------------------- • Inferior leads-------------II, III, aVF • Antero-septal leads------V1,V2,V3&V4 • Antero-lateral leads------I,aVL,V2-V6

  6. Normal ECGPR interval0.12s-0.2s(not>1 large sq)QRS duration0.12s(not>3 small squares)PQRSTST segmentisoelectricT upright

  7. ECG reporting-systematic approach • Rate • Rhythm & P waves • Conduction intervals • Axis • QRS complexes-narrow, wide, bizarre • ST segments-elevation or depression • T waves-inverted, upright, peaked

  8. How to calculate heart rate Relationship b/w R-R interval (large squares)& heart rate ------------------------------------------------------------------ R-R interval (large squares)heart rate • 1 300 • 2 150 • 3 100 • 4 75 • 5 60 • 6 50

  9. QRS nomenclature

  10. Axis

  11. Cardiac axis • Normal axis-’’ double thumbs up’’(I&III+) • RAD--- I –ve, III +ve • LAD--- I +ve, III –ve • --------------------------------------------- • RAD-(causes): normal in children, R vent hypertrophy, PE, ASD/ VSD, antero-lateral MI • LAD-inferior MI, WpW, emphysema, conduction defects

  12. Bundle branch block • RBBB • Tall R wave V1 • QRS>0.12sec • RsR-V1 • LBBB • QS-V1,V2 • QRS>0.12

  13. LBBB

  14. RBBB+LAD

  15. Atrial flutter & fibrillation • Atrial flutter • Saw tooth appearance • Rapid & regular rhythm • Atrial fibrillation • No P waves or bizarre P waves • Always irregular rhythm • Can be slow or rate controlled

  16. ACS classification

  17. Heart block • 1st degree HB-prolonged PR>0.2sec Causes-increased vagal tone, IHD, Rh fever, dig toxicity, electrolyte imbalance,myocarditis • 2nd degree HB- • Mobitz type 1 or wenckebeck-progressively increased PR,non conducted beat,short PR (causes-inf MI, athelete, drugs-Ca & beta blockers,digoxin) • Mobitz type 2-(2:1) fixed PR, one P wave not folowed by QRS-(causes-degenerative disease of conducting system, anteroseptal MI-may herald CHB)

  18. CHB or 3rd degree HB • Atrial contraction normal-no beats conducted to ventricles • Ventricles excited by slow escape rhythm • ECG-no relationship b/w P waves and Q waves • Bizarre or wide QRS complexes • Causes-degenerative fibrosis of bundle of his, MI, drugs eg betablockers, digoxin

More Related