ECG Simple Approach.pptx
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This document provides a 7-step approach to interpreting electrocardiograms (ECGs). The steps include: 1) assessing heart rate, 2) determining heart rhythm, 3) identifying the electrical heart axis, 4) measuring the PR interval, 5) analyzing the QRS complex, 6) examining repolarization in the ST-T segment, and 7) evaluating the R/S ratio. Common arrhythmias and abnormalities are described under each step along with their characteristic ECG patterns and management approaches. Assessment techniques using a caliper, pen and paper are recommended to accurately measure intervals and analyze rhythms and complexes.
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ECG Simple Approach.pptx
- 1. Dr.Sherif Magdy ECG Simple Approach
- 2. How to Interpret an ECG in 7 Steps
- 3. Step 1: Heart Rate Step 2: Heart Rhythm Step 3: Electrical Heart AXIS Step 4: The PR Interval Step 5: The QRS Complex Step 6: Repolarization ST-T Step 7: The R/S Ratio
- 4. 1-Heart Rate
- 5. Before you start Look at speed 25 mm/s.
- 10. Sinus Tachycardia Normal Sinus Rhythm with HR > 100 Management : treat the cause.
- 11. Supraventricular Tachycardia ( SVT ) • Regular , HR > 150 !! • No P or retrograde P Management : 1- Cardioversion ( DC, Medical ) 3- Radiofrequency ablation.
- 13. Atrial flutter • Regular + saw tooth P wave • may be irregular if there is variable block in AV node Management : ( like AF, transient rhythm ) 1- Cardioversion ( medical , electrical ) 2- Rate control ( BB, CCB , Digoxin ) 3- Anticoagulation
- 14. Ventricular Tachycardia ( VT, V Tach ) HR > 100 , Wide QRS > 3 small , AV dissociation Sustained VT : run of more than 30 s Non-sustained VT : run of less than 30 s Management : Cardioversion : 1- DC cardioversion. 2- Medical ( Amiodarone, Lidocain )
- 16. 2-Heart Rhythm
- 18. Pen & Paper
- 19. 3- AXIS
- 24. PR Interval Normal: 0.12 - 0.20 seconds (3 to 5 small boxes)
- 28. Left Ventricular Enlargement R ( in V5 or V6 ) > 35 ss (7 large large) + Lt axis S ( in V1 or V2 ) +
- 29. Right Ventricular Enlargement R > S in V1 S > R in V6 + Rt axis
- 31. RVH with Strain
- 32. QRS duration Normal: 0.04 - ≤ 0.10 seconds. ( ≤ 2.5 boxes)
- 33. Bundle Branch Block Simple method Wide QRS complex---- BBB Look to V1 If mainly +ve complex R ------- RBBB If mainly -ve complex ---------- LBBB
- 36. Remember if V1 is +ve Some thing Right RBBB or RVH
- 39. ST SEGMENT
- 40. Ischemic ECG Changes • ST segment elevation. • ST segment depression. • T wave flatting and inversion. • Pathological Q wave.
- 41. Stages of STEMI 1- Hyperacute T wave : Tall broad T wave. 2- ST segment elevation. 3- Q wave formation ( may occur early ) . then T wave inversion & and ST Normalization. 1 2 3
- 48. R wave progression 7-The R/S Ratio
- 53. Simply at the end
- 54. don’t small us in front of profs Remember Men are parkings للترجمة عبيد انيس معامل From the end