Systematic ECG Interpretation Guide
•Transferir como PPTX, PDF•
36 gostaram•9,018 visualizações
Ecg interpretation
Recomendados
Mais conteúdo relacionado
Mais procurados
Mais procurados (20)
Destaque
Destaque (20)
Semelhante a Systematic ECG Interpretation Guide
Semelhante a Systematic ECG Interpretation Guide (20)
Mais de SCGH ED CME
Mais de SCGH ED CME (20)
Último
Último (20)
Systematic ECG Interpretation Guide
- 1. Systematic ECG interpretation SCGH CME March 17 2016
- 2. Components of ECG Rate Rhythm Axis P PR QRS QT ST Other waves Delta Epsilon Osborne U
- 4. Rate Small square 0.04 Big square 0.2 Slow 300/big square Fast 1500/small square Irregular – count complexes on rhythm strip x 6 gives average rate Big squares rate 2 150 2.5 120 3 100 3.5 86 4 75 4.5 66 5 60 5.5 54 6 50 6.5 46 7 42
- 6. Axis differentials Left -30 to -90 LBBB LAFB LVH Inferior MI Paced rhythm Right +90 to +180 RVH LPFB Lateral MI Lung disease – acute/chronic Hyperkalemia Na channel blockade Dextrocardia NORMAL IN INFANTS and skinny adults
- 7. P WAVE PR interval 120 – 200 msec Long – any heart block Short – WPW, pre- excitation Elevation/depression - pericarditis Width < 120 msec Amplitude <2.5mm in limb leads <1.5mm in precordial leads V1 biphasic Avf inverted
- 9. QRS Amplitude Duration Q wave R wave Hypertrophy Bundle branch block J point
- 11. Q wave Pathological if >40 ms wide >2mm deep >0.25% QRS Present in leads v1-v3 > 2mm Can be normal in leads III /avR
- 12. R wave in V1 RVH - PE Posterior MI RBBB HOCM WPW Dextrocardia Normal in Kids
- 13. R Wave R wave in AVR Na channel blockade VT Dextrocardia Limb lead reversal R wave progression R wave <3mm in V3 Signifies anteroseptal MI LVH
- 14. Left Ventricular hypertrophy Voltage + non voltage Muscle wall thickens Leading to increased S wave amplitude in right sided leads Increased R wave amplitude in left sided leads Prolonged depolarisation Repolarisation abnormalities in lateral leads Causes HTN AR/AS MR HOCM
- 15. LVH voltage S in V1 + R in V5/V6 > 35mm AVL R wave 11mm Non voltage ST depression/T wave inversion in lateral leads Increased R wave peak time > 50msec in V5 V6
- 16. LVH
- 17. RVH Right axis Dominant R in V1 > 7mm or RS ratio >1 Dominant S in V6 > 7mm or RS ratio <1 RV strain – ST depression in V1-4 and inferiorly
- 18. Causes PE Chronic lung disease Pulmonary HTN Mitral stenosis Congenital heart disease Arrythmogenic RV cardiomyopathy
- 19. RVH
- 20. BBB
- 22. ST segment
- 23. J point Notching - BER Osborne wave - hypothermia
- 27. QT Ventricular depolarisation and repolarisation Calculate in lead 2 or V5 V6 Include U waves 440 msec for women 450msec for men Prolongs at slower HR QT> 500 increased risk of toursades Bezetts formula accurate over HR 60-100 HR nomogram for toxicology for risk of toursades
- 28. Long QT
- 30. T waves Inverted in V1 and AVR Can be – flat, biphasic, inverted, camel humped or hyperacute Dynamic change most important Don’t miss Wellens syndrome
- 31. Wellens Syndrome
- 32. Other Waves
- 34. Rhythm Regular, irregular, regularly irregular Heart block Atrial , AVNRT, Accessory pathways Junctional rhythm Ventricular rhythms Distinguish VT from SVT with BBB
- 37. AIVR
- 39. VT or SVT with abberancy If >35 or Hx of IHD – likely VT Look for Width > 160msec QRS VT likely Concordance Fusion beats Capture beats Right/left axis AV dissociation – p waves notching the QRS First rabbit ear taller RSR1
- 43. Children Right sided dominance as infants Should be normal by age 3-4 Rate age dependent Inverted T waves V1-4 can be normal Infant QT 490 https://www.starship.org.nz/for-health- professionals/starship-clinical- guidelines/e/electrocardiograph-ecg/
- 44. QUIZ TIME
Notas do Editor
- P pulmonale – tricuspid stenosis, pulmonary htn, cor pulmonale P mitrale, or HTN, AS, HOCM
- Clinical use - validated
- Clinical use -