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Pediatric EKG

Pediatric EKG. Pediatric EKG. Arrhythmias CHD Ischemia/Infarction Miscellaneous (Drug, Electrolyte Abnormalities, …). Pediatric EKG. Screening Diagnosis Follow up. EKG Leads. Normal Values (Davignon). P wave. Atrial Depolarization Lead II Duration (≤3y max=0.09s, >3y max=0.1s)

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Pediatric EKG

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  1. Pediatric EKG

  2. Pediatric EKG • Arrhythmias • CHD • Ischemia/Infarction • Miscellaneous (Drug, Electrolyte Abnormalities, …)

  3. Pediatric EKG • Screening • Diagnosis • Follow up

  4. EKG Leads

  5. Normal Values (Davignon)

  6. P wave • Atrial Depolarization • Lead II • Duration (≤3y max=0.09s, >3y max=0.1s) • Amplitude (max=2.5mm) • Lead V1 • Axis • Arrhythmias

  7. P wave

  8. QRS Complex • Ventricular Depolarization • Duration (V5) • Amplitude (high, low if R+S ≤ 5mm for limb leads & ≤ 10mm for precordial leads) • Axis • Morphology (QRSR’)

  9. T Wave • Ventricular repolarization • Amplitude ( high if ≥ 7mm in limb leads & ≥ 10mm in precordial leads ) • Axis

  10. T Wave Axis • I,II positive after 48 hours • aVf positive after 5 days • aVr negative • V3r, V1 negative (6 days to 6 years) • V6 positive

  11. T Wave

  12. P Wave Axis Abnormalities

  13. P Wave Axis Abnormalities

  14. RVH • qR (V1) • Pure R (V1) • T wave abnormalities (V1) • R(V1) > P98 • S(V6) > P98 • R/S(V1) > P98 • RSR’(V1) • RAD (after 3 years of age)

  15. RVHqR

  16. RVHPure R

  17. RVH Progressive T wave abnormalities

  18. RVHRSR’<1year at least 15mm>1 year at least 10mmNormal QRS duration

  19. LVH • ST segment & T wave abnormalities (I, II, aVf, V5, V6) • R(V6) > P98 • S(V1) > P98 • R(V6)+S(V1) > P98 • Deep q (V6) (> 4mm) • LAD

  20. LVH

  21. LVH

  22. BVH • Criteria for both RVH & LVH • RVH & normal forces of LV • LVH & normal forces of RV • R+S (mid-precordial leads) (Katz-Wachtel Index)

  23. * BVH * *

  24. Atrial Enlargement • Lead II (2.5×2.5) • Lead V1 (1×1)

  25. RAE • Tall P wave • Large initial deflection (V1)

  26. LAE • Broad P wave • Large terminal deflection (V1)

  27. LAE

  28. BAE • Both Criteria

  29. The End

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