EKG-undergrad.pptESS Graduate Handbook (1).pdfESS Graduate Handbook (1).pdfESS Graduate Handbook...
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Transcript of EKG-undergrad.pptESS Graduate Handbook (1).pdfESS Graduate Handbook (1).pdfESS Graduate Handbook...
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EKG (ECG)
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Modern ECG Machine
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Cardiac Conduction System
Sinoatrial (SA) node
Atrioventricular (AV) node
AV bundle (bundle of His)
Purkinje fibers
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Extrinsic Control of the Heart
PNS acts through the vagus nerve, releasing ACh todecrease heart rate and force of cardiac contraction
Hyperpolarization of the conduction cells
Absence of vagal tone, HR = 100 beats/min
Maximal vagal tone, HR = 20-30 beats/min
SNS increases rate of impulse generation and conduction
speed, increasing heart rate and force of cardiac
contraction
Maximal sympathetic stimulation, HR = 250 beats/min Epinephrine and norepinephrinereleased from the
adrenal medulla as a result of sympathetic stimulation
increase heart rate
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10 electrode placement - 12 leads
Limb Leads
I, II, III, aVR, aVL, and aVF
Electrodes placed on patients arms and legs
Chest leads (precordial)
V1, V2, V3, V4, V5, V6
Electrodes placed on patients chest
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Electrocardiogram (ECG)
An ECG provides a graphical record of theelectrical activity of the heart and can be used to
aid clinical diagnoses
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12 lead EKG
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12-Lead ECG + Rhythm Strip
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Can be determined from EKG
Rate
Rhythm Axis
Hypertrophy
Infarction
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Heart Rate-6 sec strip
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Normal Sinus Rhythm (NSR)
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Sinus Bradycardia
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Premature Atrial Contraction (PAC)
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Atrial Fibrillation
350-450 bpm
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Atrial Fibrillation
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Atrial Flutter
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Atrial Flutter
250-350 bpm, invert tracing to diagnose or
vagal stimulation
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Premature Ventricular Contraction(PVC)
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Ventricular Tachycardia(Rate 150-250 bpm)
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Ventricular Flutter
250-350 bpm, single focus
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Ventricular Fibrillation 350-450 bpm
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Flutter-Fib
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Ventricular Fibrillation(Fine and Course)
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Pacemaker
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LVH with strain (R wave amplitude V5 + Swave amplitude V1 = 35mm)
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MI-Acute vs. Old Injury
ST elevation = acute injury
Significant Q wave = old injury
(1mm wide or 1/3 amplitude of QRS)
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ST Elevation
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Significant Q waves = Old Infarction
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Locating an MI
Posteriorlarge R in V1-2; Q in V6; mirror
test
InferiorQ or ST elevation in II, II, AVF Anterior - Q or ST elevation in V1-4
LateralQ or ST elevation in I, AVL, V5-6
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Acute Anterior MI
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Acute Inferior MI
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Acute Lateral MI
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Acute Posterior MI
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Old Inferior MI
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