Anatomy.

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Presentation transcript:

Anatomy

ECG Electrodes

ECG Waveform

The 12 lead ECG

How does the heart work

AV node activated by Atrial depolarization Sends signal through His-purkinje bundle Get depolarization of SEPTUM Left and Right BUNDLES transmit signal to Left and Right VENTRICLES Net “Vector” towards the LV Should be narrow (<120msec) if bundles working properly Then have REPOLARIZATION = Twave The appearance of this electrical activity depends on which lead you are using to look at it

Review of waveforms

How to Look at an ECG Rate: Is the heart rate too fast or slow? Rhythm: Sinus rhythm or not? Axis: Where does the majority of electrical activity point? P wave: How big are the atria? PR interval: How healthy is the AV node? QRS wave: Is there abnormal conduction or a ventricular source? QT: Long is bad Ischemia and hypertrophy

ECG Paper Can Determine Heart Rate Rule: 300, 150, 100, 75, 60, 50 counting over for each big sqaure

What is the heart rate? Answer = 75 per min

Rhythm : Is there a p wave? = Sinus Is it followed by a QRS?

Is the rhythm regular or irregular?

Reasons to have an irregular rhythm Irregular pacemaker Multifocal atrial rhythm Atrial fibrillation Atrial fib/flutter Ectopic beats PVC PAC PJC Irregular conduction AV node block 1st degree: PR interval > 200 msec 2nd degree: Type 1: Wenkebach Type 2: dropped beat 3rd degree: p waves marching independent to QRS

Examples of Rhythms Multifocal Atrial Rhythm AFIB Atrial Flutter AFIB V TACH

Example of a PVC

Telling the Axis from the leads

The axis wheel

The P wave

The QRS QRS < 120 msec QRS > 120 msec QRS > 120 msec Rabbit ears in V1 & V2 Wide S wave in V5 & V6 R axis deviation QRS > 120 msec Deep slurred S wave in V1 Wide R wave in V6, I & avL L axis deviation

Ishcemia vs Acute Infarct

Example of Ischemia

Examples of Infarctions

Review Rate: Is the heart rate too fast or slow? Rhythm: Sinus rhythm or not? Axis: Where does the majority of electrical activity point? P wave: How big are the atria? PR interval: How healthy is the AV node? QRS wave: Is there abnormal conduction or a ventricular source? QT: Long is bad Ischemia and hypertrophy

Describe this ECG

Describe this Strip