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ELECTROCARDIOGRAM (ECG) Cardiovascular System Physiology Lab Interpretation Dr.Mohammed Sharique Ahmed Quadri Asst. professor in physiology بسم الله الرحمن الرحيم
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ANALYZING INDIVIDUAL WAVES & SEGMENTS P wave : upright except in avR Normal duration: 0.08 to 0.11 sec do you see p waves ? are all p waves same ? does all QRS complexes have p waves ? P-R interval : Normal range 0.12 – 0.20 sec Is the PR interval constant ? If prolong indicates various blocks 2
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ANALYZING INDIVIDUAL WAVES & SEGMENTS QRS complexes: Are the p waves & QRS complexes are associates with each other Are the QRS complexes narrow or wide ST Segment : Normal : Isoelectric Elevation : in acute MI Depression : in ischemia T wave: Tall T wave : ischemia, hyperkalemia Inverted : young children,deep inspiration, bundle branch block, ischemia,hypokalemia 3
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ANALYZING INDIVIDUAL WAVES & SEGMENTS QT INTERVAL: 0.4 to 0.43 seconds depending upon heart rate. At high heart rates, ventricular action potentials shorten in duration, which decreases the Q-T interval.. prolonged in acute MI,hypocalcaemia 4
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Variation in ST segment
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One way to diagnose an acute MI is to look for elevation of the ST segment.
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Elevation of the ST segment (greater than 1 small box) in 2 leads is consistent with a myocardial infarction.
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Do you think this person is having a myocardial infarction. If so, where? Yes, this person is having an acute anterior wall myocardial infarction.
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Now, where do you think this person is having a myocardial infarction? Inferior wall MI
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How about now? Anterior & lateral wall MI
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NORMAL HYPERKALEMIA HYPOKALEMIA 13
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INTERPRETE THE ECG ? HYPERKALEMIA Observe Tall T - wave 15
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REPORTING OF ECG This ecg shows Sinus rhythm Heart rate of 75/ min Normal QRS axis Normal PR interval 0.12 sec Normal QRS duration 0.8 sec ST segment isoelectric in all leads T wave normal & upright in all wave except in aVR 16
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REFERENCES Text book of medical physiology by GUYTON & HALL 11 th edition Text book physiology by GANONG The ECG made Easy by John R.Hampton sixth edition The guide to EKGinterpretation by JohnA.Brose, D.O,John C.Auseon 17
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Prof. Magdy El-Barbary
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Suggestive of Question NO: What is the most likely cause of changes in ST seg. & T wave of each diagram?
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Ways the ECG can change include: Appearance of pathologic Q-waves T-waves peaked flattened inverted ST elevation & depression
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Text book of medical physiology by GUYTON & HALL 11 th edition Text book physiology by GANONG The ECG made Easy by John R.Hampton sixth edition The guide to EKGinterpretation by JohnA.Brose, D.O,John C.Auseon
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