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Basics of ECG

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Basics of ECG

  1. 1. PRESENTED BY : Raghwender Singh (D- 754) THE BASICS OF EKG
  2. 2. INRODUCTION <ul><li>ECG or EKG </li></ul><ul><li>ECG is essential for diagnosis </li></ul><ul><li>Essential in management of cardiac rhythm </li></ul><ul><li>Helps in diagnosis of chest pain </li></ul><ul><li>Proper use of thrombolysis in treatment of MI depend upon it </li></ul>
  3. 3. HISTORY <ul><li>1842- Italian scientist Carlo Matteucci realizes that electricity is associated with the heart beat </li></ul><ul><li>1872- French scientist Gabriel Lippmann , invented the capillary electrometer which can measure electricity by utilizing mercury </li></ul><ul><li>1876- Irish scientist Marey analyzes the electric pattern of frog’s heart </li></ul>
  4. 4. CONTD… <ul><li>1895 - William Einthoven , credited for the invention of EKG </li></ul><ul><li>1906 - using the string electrometer EKG, </li></ul><ul><li>William Einthoven diagnoses some heart problems </li></ul><ul><li>1924 - the noble prize for physiology or medicine is given to William Einthoven for his work on EKG </li></ul>
  5. 6. MODERN ECG INSTRUMENT
  6. 7. ELECTRICITY OF HEART <ul><li>Contraction of any muscle is associated with electrical charges called depolarization </li></ul><ul><li>These changes can be detected by electrodes attached to the surface of the body </li></ul><ul><li>Although the heart has 4 chambers, from the electrical point it is having only 2 </li></ul>
  7. 8. THE WIRING DIAGRAM OF THE HEART <ul><li>SA </li></ul><ul><li>AV node </li></ul><ul><li>Bundle of His </li></ul><ul><li>Bundle branches (left and right) </li></ul>
  8. 9. THE SHAPE OF ECG <ul><li>Contraction of atria - P wave </li></ul><ul><li>Ventricular depolarization - QRS complex </li></ul><ul><li>Ventricular repolarization - T wave </li></ul>
  9. 10. NORMAL ECG
  10. 11. ECG INTERPRETATION
  11. 12. RELATIONSHIP BETWEEN THE NUMBER OF LARGE SQUARES COVERED BY R-R INTERVAL AND THE HEART RATE R-R INTERVAL(large squares) HEART RATE (beats/min) 1 300 2 150 3 100 4 75 5 60 6 50
  12. 13. ECG RHYTHM
  13. 14. NORMAL SINUS RHYTHM <ul><li>Looking at the ECG you'll see that:- </li></ul><ul><li>RHYTHM - Regular </li></ul><ul><li>RATE - (60-100 bpm) </li></ul><ul><li>QRS DURATION - Normal </li></ul><ul><li>P WAVE - Visible before each QRS complex </li></ul><ul><li>P-R INTERVAL - Normal (<5 small Squares. Anything above and this would be 1st degree block) </li></ul><ul><li>Indicates that the electrical signal is generated by the sinus node and travelling in a normal fashion in the heart. </li></ul>
  14. 15. NORMAL SINUS RHYTHM
  15. 16. SINUS BRADYCARDIA <ul><li>Looking at the ECG you'll see that:- </li></ul><ul><li>RHYTHM - Regular </li></ul><ul><li>RATE - Less than 60 beats per minute </li></ul><ul><li>QRS DURATION - Normal </li></ul><ul><li>P WAVE - Visible before each QRS </li></ul><ul><li>complex </li></ul><ul><li>P-R INTERVAL - Normal </li></ul><ul><li>Usually benign and often caused by patients on beta blockers </li></ul>
  16. 17. SINUS BRADYCARDIA
  17. 18. SINUS TACHYCARDIA <ul><li>Looking at the ECG you'll see that:- </li></ul><ul><li>RHYTHM - Regular </li></ul><ul><li>RATE - More than 100 beats per minute </li></ul><ul><li>QRS DURATION - Normal </li></ul><ul><li>P WAVE - Visible before each QRS complex </li></ul><ul><li>P-R INTERVAL - Normal </li></ul><ul><li>The impulse generating the heart beats are normal, but they are occurring at a faster pace than normal. Seen during exercise </li></ul>
  18. 19. SINUS TACHYCARDIA
  19. 20. ECG RULES <ul><li>If you follow Professor Chamberlains 10 rules they'll give you an understanding of what is normal:- </li></ul>
  20. 21. RULE 1 <ul><li>PR interval should be 120 to 200 milliseconds or 3 to 5 little squares </li></ul>
  21. 22. RULE 2 <ul><li>The width of the QRS complex should not exceed 110 ms, less than 3 little squares </li></ul>
  22. 23. RULE 3 <ul><li>The QRS complex should be dominantly upright in leads I and II </li></ul>
  23. 24. RULE 4 <ul><li>QRS and T waves tend to have the same general direction in the limb leads </li></ul>
  24. 25. RULE 5 <ul><li>All waves are negative in lead aVR </li></ul>
  25. 26. RULE 6 <ul><li>The R wave must grow from V1 to at least V4 </li></ul><ul><li>The S wave must grow from V1 to at least V3 </li></ul><ul><li>and disappear in V6 </li></ul>
  26. 27. RULE 7 <ul><li>The ST segment should start isoelectric except in V1 and V2 where it may be elevated </li></ul>
  27. 28. RULE 8 <ul><li>The P waves should be upright in I, II, and V2 to V6 </li></ul>
  28. 29. RULE 9 <ul><li>There should be no Q wave or only a small q less than 0.04 seconds in width in I, II, V2 to V6 </li></ul>
  29. 30. RULE 10 <ul><li>The T wave must be upright in I, II, V2 to V6 </li></ul>
  30. 31. REFERENCES:- <ul><li>The EKG made easy-John R. Hampton </li></ul><ul><li>www.ambulancetechnicianstudy.co.uk </li></ul><ul><li>www.learntheheart.com </li></ul>

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