berisi tentang ECG interpretation

1. HOW TO READ
ELECTROCARDIOGRAPHY
Department of Cardiology and Vascular Medicine
Faculty of Medicine University of Indonesia
National Cardiovascular Center Harapan Kita

7. Unipolar Precodial (Chest) Leads
Midclavicular line
Anterior axillary line
Midaxillary line
V6R V6
V5
V5R
V4
V4R V3
V3R V2
V1
Mervin J. Goldman, MD. 11th edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of
California School of Medicine San Francisco @1995-1982

8. Unipolar Precodial (Chest) Leads
Horizontal plane of V 4-6
V7 V8 V9 V 9R V 8R V 7R
Mervin J. Goldman, MD. 11th edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of
California School of Medicine San Francisco @1995-1982

10. The electrocardiogram
(ECG) illustrates
conduction of electrical
impulses in the heart.
The depolarization of the
ventricles occurs from
the endocardium
(inside) to the
epicardium (outside)
[e]
The repolarization of the
ventricles occurs in the
opposite direction. [g]

14. ECG INTERPRETATION
1. RATE
2. RHYTHM
3. AXIS
4. HIPERTROPHIC SIGNS
5. MYOCARDIAL INFARCTION
6. ARRHYTHMIA

15. 1. RATE
Normal heart rate : 60 – 100 x/minutes
• > 100 x/minutes : Sinus Tachycardia
• < 60 x/minutes : Sinus Bradicardia
Determination heart rate (normal paper speed 25 mm/s):
• 300
Count number of large square (bold boxes in one R – R’ interval)
• 1500
Count number of small square in one R – R’ intervals
• Number of QRS complex in 6 seconds, multiply by 10

17. 2. RHYTHM
Normal cardiac rhythm : SINUS rhythm
Sinus rhythm characteristics :
• Rate 60-100 bpm
• Constant R – R interval
• Negative P wave in aVR and positive di II
• P wave is always followed by QRS complex

18. 3. AXIS

22. 4. HYPERTROPHIC SIGNS

26. 5. MYOCARDIAL INFARCTION
 Ischemia
 Injury
 Necrosis

30. ANTERIOR INFARCTION

31. INFERIOR INFARCTION

32. POSTEROLATERAL INFARCTION

33. ARRHYTHMIA

34. AV BLOCK

40. WHAT’S WRONG??
Lead Error: V1 and V3 are Transposed!
In this normal 12-lead ECG the V1 and V3 chest electrodes are
interchanged. Experienced ECG interpreters should be able to spot this
lead placement error.

57. DISCUSSION

59. Sinus arrhythmia

60. Limb lead reversal

61. Early repolarization

62. Subendocardial ischemia.
Anterolateral ST-segment depression

63. Unstable angina

64. acute anterolateral myocardial infarction

65. High lateral infarction

66. Lateral myocardial infarction

67. Right ventricular infarction

68. Acute inferoposterior myocardial infarction

69. left ventricular aneurysm

70. Mobitz I

72. High-grade atrioventricular block

73. Wolff-Parkinson-White syndrome

74. Wolff-Parkinson-White syndrome

75. Atrial fibrillation

76. Atrial flutter

77. premature ventricular contraction

78. Supraventricular tachycardia

79. Wide complex tachycardia

80. Ventricular flutter

81. Idioventricular rhythm