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ECGs

ECGs. Overview. Understand why you get an ECG Identify some common ECG abnormalities. Blood pathway in the heart. Electrical pathway in the heart. Cardiac conduction system. 1. Sinoatrial (SA) node 2. Atrioventricular (AV) node 3. Atrioventricular bundle 4. Left and Right Bundles of His

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ECGs

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  1. ECGs

  2. Overview • Understand why you get an ECG • Identify some common ECG abnormalities

  3. Blood pathway in the heart

  4. Electrical pathway in the heart

  5. Cardiac conduction system • 1. Sinoatrial (SA) node • 2. Atrioventricular (AV) node • 3. Atrioventricular bundle • 4. Left and Right Bundles of His • 5. Purkinje Fibres • 6. Branch of left bundle branch

  6. Electrical Anatomy

  7. Normal ECG

  8. Chest lead placement

  9. Lead placement • V1 - 4th Intercostal space, right sternal border • V2 - 4th Intercostal space, left steral border • V3 - Mid way between V2 and V4 • V4 - 5th Intercostal space, mid clavicular line • V5 - Anterior axillary line, horizontal to V4 • V6 - Mid axillary line, horizontal to V4 and V5

  10. ECG abnormalities • Atrial • Rate • arrthymia • Atioventriclular • Blocks • Ventricular • conduction • Ectopics Unifocal, multifocal • Arrthmias VT, VF • ST segments • Elevation • Depression • Concave

  11. Atria • Sinus bradycardia • Sinus Tachycardia • Atrial Flutter • Atrial fibrillation • SVT

  12. Sinus bradycardia

  13. Sinus Tachycardia

  14. Atrial Flutter

  15. Atrial fibrillation

  16. SVT Supraventricular Tachycardia Anything quick originating in the atria Sinus tachycardia Wolf Parkinson White Atrial flutter Atrial fibrillation

  17. A-V Node • 1st degree Prolonged PR interval • 2nd degree intermittent conduction failure • Type I (Wenckebach) conduction velocity progressively slows down until failure of conduction occurs • Type II (Mobitz). is all or none. • N to 1 block • 3rd degree complete conduction failure In addition, 2nd degree heart block occurs in two varieties:

  18. 1st Degree

  19. Type I (Wenckebach)

  20. Type II (Mobitz)

  21. N to 1 block - 2 to 1 block

  22. 3rd Degree B post pacemaker

  23. Venticular • Conduction • LBBB • RBBB • WILLIAM MARROW • Ectopics • Single • Multiple • Arryhmia • VT • Torsades • VF

  24. To differentiate atrial and ventricular activity

  25. Left Bundle branch block

  26. Right bundle branch block

  27. Single ectopic

  28. Multiple ectopics

  29. Ventricular Tachycardia Ventricular tachycardia

  30. Ventricular Fibrillation

  31. ST Elevation

  32. ST Depression

  33. ST Concave

  34. Smart Arses

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