Ecg Essentials

ECG Essentials Steven J. Sager, MPAS, PA-C PAC5229 - Electrocardiography

Learning Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Learning Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Six Essential Lists ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Evaluating regular, narrow-complex tachycardia ,[object Object],[object Object],[object Object],[object Object]

Hemodynamically stable? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causes of regular, narrow-complex tachycardia

Treatment of regular, narrow-complex tachycardia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causes of regular, wide-complex tachycardia (WCT)

Treatment of regular, WCT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

QT prolongation ,[object Object],[object Object],[object Object],[object Object]

Causes of QT prolongation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Causes of QT prolongation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Common causes of ST segment depression ,[object Object],[object Object],[object Object],[object Object],[object Object]

Common causes of a tall R wave in lead V 1 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Differentiate the causes of a tall R wave in lead V 1 Causes QRS ECG ∆’s W-P-W Widened Delta waves Short PR interval RBBB Widened rSR ´ in V 1 Wide terminal S wave in I and V 6 RVH Normal RAD R ventricular strain Infarct Normal Changes in inferior leads Positive “mirror test”

60 y.o. ♂ with history of heart disease. 72 y.o. ♀ with history of palpitations. 28 y.o. ♂ with no medical problems or heart disease. 66 y.o. ♂ 2ppd smoker with history of COPD. 48 y.o. ♂ with new onset chest pain.

Causes of anterior ST segment depression in the setting of acute inferior infarct ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Why 12-lead vs. 1-lead? ,[object Object],[object Object],[object Object],[object Object]

60 y.o. ♀ c/o rapid heart beat. Denies CP. No meds. B/P = 140/90mmHg ,[object Object],[object Object],[object Object],[object Object],[object Object]

50 y.o. ♂ with CAD c/o rapid heart beat. Denies CP. B/P = 160/100mmHg ,[object Object],[object Object],[object Object],[object Object],[object Object]

60 y.o. ♂ with COPD c/o wheezing & mild dyspnea. Hx of rapid heart beats. B/P = 130/80mmHg.

60y.o. ♂ c/o “palpitations”

Comparing Tracings ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Important Comparison Points to Consider ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Benefits of Computer Analyses ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Are Computer Analyses Accurate? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Reviewing a Computer Analysis √ √ Agree as corrected. S. J. Sager, PA-C Intervals/durations in milliseconds Date & time are CRITICAL! Includes patient identification

Thought for the day! ,[object Object],[object Object]

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