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Ec gs for medical student

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Transcript

  • 1. All what you need to know about EKG
  • 2. Each lead looks at the heart
  • 3. Normal waves and segments
  • 4. Reading ECG Rhythm Rate Axis Chamber enlargement Ischemia ( ST, T, Q and LBBB) Intervals( PR, QRS, QT) Conclusion
  • 5. Normal ECG Each P is followed by QRS P wave is + in I and AVL Rate is between 60-100 P wave is less than 2.5 mm in height and less than 0.11 mm in width PR interval 0.12-0.2 mm Normal QRS less 0.12 mm Normal QT is 0.42 mm Normal ST is isoelectric with PR or TP
  • 6. Axis both I and aVF +ve = normal axis both I and aVF -ve = axis in the Northwest Territory lead I -ve and aVF +ve = right axis deviation lead I +ve and aVF -ve lead II +ve = normal axis lead II -ve = left axis deviation
  • 7. Rate  Or 300 divided by the number of the large squares divided  Or number of the QRSs multiplied by 10 (AF)
  • 8. Right atrial enlargement P wave 3 mm ( 3 small squares) or greater in height in inferior leads P wave 1.5 mm (1.5 small squares ) or greater in lead V1 The P wave has a sharp and peaked appearance
  • 9. Left atrial enlargement P wave notched and exceeds 120 ms ( 3 small squares) in the inferior leads The negative terminal component of P wave in V1 exceeds 40 ms ( 1 small squares )
  • 10. Left ventricular hypertrophy S in lead V1 plus R in either V5 or V6 greater than 35 mm R wave in lead aVL greater than 11 mm
  • 11. Right ventricular hypertrophy Right axis deviation Dominant R in V1 RAE R wave 7 mm ( 7 small squares) or greater
  • 12. 38 y M with CP
  • 13. 67y F HD CP at 0400am
  • 14. 65 y M with 1h CP
  • 15. 45y M CP for 13 h vitals stable
  • 16. 59 y F with 5h CP
  • 17. 56 y M with 3h CP
  • 18. 45 y M with 3h CP
  • 19. 62 y F with 45 min CP
  • 20. 59 y F 4h CP and BP 65/40
  • 21. 63 y F 5h CP BP 64/32