origin of ECG , few discoveries ,followed by normal e c g ,,,and at the end localise M I ....

1. ECG
PHYSIOLO
GY
&
LOCALISA
TION OF
MI

2. LUIGI GALVANI

3. PLAN
 1 RECALL THE GREAT WORK
OF LEGENDS
 2 REVISE THE PRESENT
 3 APPLY TO SAVE LIVES

4. ..
1 HISTORY AND GROUND BREAKING
ADVANCES
2 BRIEF REVIEW ON HEART AND
ELECTRICITY AND MECHANICS
3 LEADS APPLICATION
4 ECG READING
5 MI PPATHOPHYSIOLOGY
6 ECG IN MI

5. Luigi galvani
While working in lab ,he noticed
contraction of leg muscles when
scalpel touched the nerve.
Proposed mechanism-Animal
electricity
This formed the basis of
ELECTRICITY AND CONTRACTION
OF HEART

6. 1780- Luigi galvani

8. SIR HANS
CHRISTIAN
OERSTED…
PLATINUM WIRE HEATING WITH ELECTRICITY
CAUSED MOVEMENT OF COMPASS NEEDLE.

9. JOHANN
SCHWEIGGER
 Proposed that current carrying
wire produces magnetic field.
 he invented GALVANOMETER

10. .
 CARLO MATEUCCI
 EMIL DUBOIS –REYMOND
made further improvements to
the galvanometer by
increasing turns of the wire on
the coil to 24,000 ( 5 km wire )

12. 1872 –capillary
electrometer
by GABRIAL
LIPPMANN
Open the chest
,expose the heart
and connect
electrodes and
measure the rise
/fall of potential

13. AUGUSTUS DESIRE
WALLER -electrogram
 1ST person to attempt non
invasive measuring of heart s
electricity.
 As the voltage in heart is <1
mv he tried a new technique.
 He shone a light through
meniscus and projected on to
a moving photographic plate

15. Waller s
OBSERVATIONS
 ECF surrounding heart acts as
a continuous conducting
medium between hearta and
skin.
 Postulated that spread of
electricity is from apex to atria

16. ORIENTATION OF
HEART

17. EINTHOVEN
 ENHANCED ELECTROMETER
 DEFLECTIONS NAMING AS P,Q
,R,S,T – FOLLOWED RENE
DISCARTES, MATHEMATICIAN
AND METAPHYSICIST OF 17 TH
CENTURY WHO REPRESENTED
MATHEMATIC DEPECTIONS
WITH P ,Q, …..

18. Einthoven triangle
 Based on various permutaitons
and combinations of placing
electrodes,einthoven finally
used 3 leads – LIMB LEADS
1,2,3
 LEAD3 EQUALS DIFFERENCE
BETWEEN LEAD 2 AND 1

21. Nobel prize 1924
For contributions in
medicine

22. Wilson terminal

23. Wilson s central
terminal
 Wilson incorporated 5 k ohms
resistance to each electrode
and combined 3 electrodes
to form wilsons central termina
 Leads-
 VR-R arm paired with average
of left arm and left foot
 VF-left foot paired with
average of right and left arms
 VL-left arm paired with
average of left foot and right
arm

24. Goldberger s
augmented leads
 He increased the voltages by
50 percent by increasing
resistance
 V=IR
 Avr,……

25. .
 1912- James B Herrick reported
clinico –pathological
correlation of sudden
coronary artery occlusion.
 Dr .fred smith –described
typical ecg patterns in 60 dogs
.
 He opened chests and tied
each coronary arteries with
strong linen , closed the chest
and recorded ecg ,observed
different pattern in each
artery……

26. .
 1938-AMERICAN HEART
ASSOCIATION – defined
standard positions of
precordial leads