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    Basics of ECG Interpretation

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    ramish.riaz
    How to interpret ECG

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    Basics of ECG Interpretation

    Uploaded by

    ramish.riaz
    30 views31 pages
    How to interpret ECG

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    © © All Rights Reserved

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    How to interpret ECG

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    © All Rights Reserved
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    Download as pptx, pdf, or txt
    30 views31 pages

    Basics of ECG Interpretation

    Uploaded by

    ramish.riaz
    How to interpret ECG

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 31

    BASICS OF ECG

    INTERPRETATIO
    N

    Dr. Ramish Riaz

    Assistant Professor, HOD MIT

    Riphah International University


    ELECTROCARDIOGR
    AM
    The electrocardiogram (EKG) is a representation of the electrical events of
    the cardiac cycle.
    Each event has a distinctive waveform, the study of which can lead to greater
    insight into a patient’s cardiac pathophysiology.
    It is waveform components that consist of the electrical events
    during one heartbeat The waveforms are labeled as P, Q, R, S, T &
    U

    2
    ECG
    • Wave: A positive or negative deflection from baseline that indicates a specific electrical
    event. The waves on an ECG include the P wave, Q wave, R wave, S wave, T wave and
    U wave.
    • Interval: The time between two specific ECG events. The intervals commonly measured
    on an ECG include the PR interval, QRS interval (also called QRS duration), QT interval
    and RR interval.
    • Segment: The length between two specific points on an ECG that are supposed to be at
    the baseline amplitude (not negative or positive). The segments on an ECG include the
    PR segment, ST segment and TP segment.
    • Complex: The combination of multiple waves grouped together. The only main complex
    on an ECG is the QRS complex.
    • Point: There is only one point on an ECG termed the J point, which is where the QRS
    complex ends and the ST segment begins.
    ECG
    • The P wave indicates atrial depolarization. The QRS complex consists of a Q

    wave, R wave and S wave and represents ventricular depolarization. The T

    wave comes after the QRS complex and indicates ventricular repolarization.

    The U wave is said to represent repolarisation of the Purkinje fibres.

    4
    ECG LEADS
    Leads are electrodes which measure the difference in electrical
    potential between either:
    • Two different points on the body (bipolar leads)
    • Two different points on the body (bipolar leads)
    • One point on the body and a virtual reference point with zero
    electrical potential, located in the center of the heart (unipolar
    leads)

    The standard EKG has 12 leads:


    3 Standard Limb Leads
    3 Augmented Limb Leads
    6 Precordial Leads
    The axis of a particular lead represents
    the viewpoint from
    which it looks at the heart.
    ECG LEADS

    6
    ECG LEADS

    7
    ECG INTERPRETATION
    • Width indicates time, height indicates
    voltage
    • One small box on x-axis=0.04sec
    • One large box on x-axis=0.2sec
    (200msec)
    • 5 boxes indicate 1 sec
    • One small box on y-axis=0.1mV
    • One large box on x=y-axis=0.5mV
    • Speed of paper is 25mm/s
    • Big square=5mm *5mm
    • In 1 sec, 5 big square passed

    8
    ECG INTERPRETATION

    • Rate
    • Rhythm
    • Axis
    • Waves
    • Segments
    • Intervals
    9
    RATE
    • To calculate the rate of a regular
    ECG, simply divide
    • 300 by the number of large
    squares between two
    • complexes.
    • For irregular rhythms, count the
    number of complexes
    • between 30 large squares and
    multiply by 10 (30 large squares
    = 6 seconds, assuming standard
    paper speed of 25 mm/s)

    10
    RATE

    11
    RHYTHM
    • Rhythm Strip: II (at
    end)
    • Is there a single,
    regular P before
    every Q wave?
    • Mark out the RR
    patterns on a piece of
    paper to see if the
    intervals are the
    same
    • Regularly irregular:
    In a reoccurring
    12
    irregular pattern
    RHTHYM

    13
    AXIS

    14
    AXIS

    In the event that LAD is present, examine lead II to


    determine if this deviation is pathologic. If the QRS in
    II is
    predominantly positive, the LAD is non—non-
    pathologic (in other pathologic (in other words, the 15
    INTERVALS

    16
    INTERVALS

    17
    WAVES

    18
    WAVES

    19
    WAVES

    20
    SEGMENTS

    21
    22
    DISEASES &
    THEIR
    INTERPRETATION
    S

    23
    24
    25
    26
    27
    28
    A 59-year-old smoker with a
    history of DM2, HLD and HTN
    presents for acute onset crushing
    chest pain.

    The ECG shows classic findings of


    acute/hyperacute anterior wall Q wave
    myocardial infarction (MI), with
    reciprocal inferior ST depressions.

    29
    30
    THANK YOU

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