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HOW TO READ ELECTROCARDIOGRAPHY. SYARIF HIDAYATULLAH STATE ISLAMIC UNIVERSITY (UIN), JAKARTA. Dr. Yasmin Tadjoedin , Sp.JP. ECG INTERPRETATION. RATE RHYTHM AXIS HIPERTROPHIC SIGNS MYOCARDIAL INFARCTION ARRHYTHMIA. Rhytm QRS Rate QRS Axis P wave PR Interval QRS Duration - PowerPoint PPT Presentation
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HOW TO READ ELECTROCARDIOGRAPHY
SYARIF HIDAYATULLAH STATE ISLAMIC UNIVERSITY (UIN), JAKARTA
Dr. Yasmin Tadjoedin, Sp.JP
ECG INTERPRETATION
1. RATE 2. RHYTHM 3. AXIS 4. HIPERTROPHIC SIGNS 5. MYOCARDIAL INFARCTION 6. ARRHYTHMIA
STEPS IN ECG READING :
• Rhytm• QRS Rate• QRS Axis• P wave• PR Interval• QRS Duration• QRS Morphology • ST Segmen Deviation• T wave morphology• U wave• Others (LVH,LV Strain,BBB, QT
interval)• ECG conclusion
NORMAL VALUES :
PR Interval 0,12’’ - 0,20’’
QRS Duration 0,04’’ - 0,12’’
Normal Axis - 300 - + 1100
1. RATENormal 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
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
3. AXIS
4. HYPERTROPHIC SIGNS
LEAD II
LEAD V1
5. MYOCARDIAL INFARCTION
• Ischemia• Injury• Necrosis
ANTERIOR INFARCTION
INFERIOR INFARCTION
POSTEROLATERAL INFARCTION
ARRHYTHMIA
AV BLOCK
Complete heart block
COMPLETE LEFT BUNDLE BRANCH BLOCK (LBBB)
COMPLETE RIGHT BUNDLE BRANCH BLOCK (RBBB)
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.