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    Electrocardiograph Y (ECG / Ekg) : Rose Dyane F - Nunag, RMT, MPH

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    Claire Gono
    An electrocardiogram (ECG or EKG) records and measures the electrical activity of the heart. It is a painless and noninvasive test that can detect abnormalities in heart rhythm and diagnose heart conditions. The ECG attaches electrodes to the skin on the wrists, ankles, and chest to detect the tiny electrical changes on the skin that arise from the heart muscle's electrophysiologic pattern of depolarizing and repolarizing during each heartbeat. The ECG tracing produced provides important information about the heart's electrical conduction and can help identify conditions like arrhythmias, ischemia, infarction, and more.

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    Electrocardiograph Y (ECG / Ekg) : Rose Dyane F - Nunag, RMT, MPH

    Uploaded by

    Claire Gono
    37 views52 pages
    An electrocardiogram (ECG or EKG) records and measures the electrical activity of the heart. It is a painless and noninvasive test that can detect abnormalities in heart rhythm and diagnose heart conditions. The ECG attaches electrodes to the skin on the wrists, ankles, and chest to detect the tiny electrical changes on the skin that arise from the heart muscle's electrophysiologic pattern of depolarizing and repolarizing during each heartbeat. The ECG tracing produced provides important information about the heart's electrical conduction and can help identify conditions like arrhythmias, ischemia, infarction, and more.

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    2- ECG

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    An electrocardiogram (ECG or EKG) records and measures the electrical activity of the heart. It is a painless and noninvasive test that can detect abnormalities in heart rhythm and diagnose heart conditions. The ECG attaches electrodes to the skin on the wrists, ankles, and chest to detect the tiny electrical changes on the skin that arise from the heart muscle's electrophysiologic pattern of depolarizing and repolarizing during each heartbeat. The ECG tracing produced provides important information about the heart's electrical conduction and can help identify conditions like arrhythmias, ischemia, infarction, and more.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    37 views52 pages

    Electrocardiograph Y (ECG / Ekg) : Rose Dyane F - Nunag, RMT, MPH

    Uploaded by

    Claire Gono
    An electrocardiogram (ECG or EKG) records and measures the electrical activity of the heart. It is a painless and noninvasive test that can detect abnormalities in heart rhythm and diagnose heart conditions. The ECG attaches electrodes to the skin on the wrists, ankles, and chest to detect the tiny electrical changes on the skin that arise from the heart muscle's electrophysiologic pattern of depolarizing and repolarizing during each heartbeat. The ECG tracing produced provides important information about the heart's electrical conduction and can help identify conditions like arrhythmias, ischemia, infarction, and more.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 52

    ELECTROCARDIOGRAPH

    S p e c i a l D i a g n o s t i c P r o c e d u r e s 311
    (ECG /
    EKG)

    ROSE DYANE F . NUNAG, RMT,


    MPH
    Electrocardiogra
    m
    An electrocardiogram records the electrical signals in your heart. It's a
    common and painless test used to quickly detect heart problems and
    monitor your heart's health. Electrocardiograms — also called ECGs or
    EKGs — are often done in a doctor's office, a clinic or a hospital
    room.
    Histo
    ry
    Brief History of ECG
    1786 – Dr. Luigi Galvani first noted that electrical current could be recorded
    from skeletal muscles.
    1887 – The first ‘electrogram’ (ECG) from the intact human heart was recorded
    with a mercury capillary electrometer by Augustus D Waller at St. Mary’s Hospital,
    London. 1895 – Einthoven, using an improved electrometer and a correction formula
    developed independently. He labeled the corrected derived deflections PQRS and
    T.
    1900 – First article source using the term “Elektrokardiogramm” (EKG) by
    Willem
    Einthoven
    1902– Einthoven publishes the first
    electrocardiogram recorded on a string
    galvanometer.
    identify irregular heart rhythms suggestive of atrial From : U . S . Food and Drug Administration

    2018 – Apple smart watch: Over 400,000 people enroll in a study being
    fibrillation.
    Types of
    ECG
    Resting ECG Training
    Exercise/Stress ECG
    Training Holter
    Monitor
    Types of
    ECG
    Resting ECG Training
    standard test for measuring heart’s electrical function
    records your heart’s electrical activity from 12
    electrodes (sticky patches) on your chest, arms, and
    legs at the same time.
    Types of
    Exercise/StressECG
    ECG Training
    AKA: stress test, treadmill test or
    exercise EKG
    walks on a treadmill or pedals a
    stationary bicycle
    Breathing and blood pressure rates
    are also monitored.
    used to detect coronary artery
    disease, and/or to determine safe
    levels of exercise following a heart
    attack or heart surgery.
    Types of
    ECG
    Holter Monitor
    a type of electrocardiogram (ECG or EKG) used to monitor
    the ECG tracing continuously for a period of 24 hours
    or longer.
    Examination Protocol
    Pre-Examination
    Remove any jewelry or other objects that may interfere with
    the test.
    Depending on the reason for your ECG, your doctor
    may ask you to stop taking some of your
    medications.
    Examination
    Remove clothing from the
    waist up. Lie flat on a table
    or bed for the test.
    If your chest, arms, or legs are very hairy, the technician may
    shave or clip small patches of hair, as needed, so that the
    Examination Protocol
    Once the leads are attached, the
    technician may enter identifying
    information about you into the machine's computer.
    The ECG will be started. It will take only a short time for the
    tracing to be completed.
    Once the tracing is completed, the technician will disconnect the
    leads and remove the skin electrodes.
    ECG Setup
    ECG Setup

    Eindhoven's
    Triangle
    ECG Leads
    Bipolar Limb Leads - register the voltage between two
    electrodes

    Lead 1:
    (-) right arm and left
    arm (+) Lead 2:
    (-) right arm and left
    leg (+) Lead 3:
    (-) left arm and left
    leg (+)
    ECG Leads
    Unipolar Limb Leads - register activity in the heart which is
    directed towards, or located below the electrode
    The ECG machine usually augments the potential by 1.5 than
    original potential
    Comes from a central terminal

    Lead 1: (-) right arm and


    left arm (+) Lead 2: (-) right
    arm and left leg (+) Lead 3:
    (-) left arm and left leg (+)
    V1 and V2: negative
    because the chest leads
    are nearer to the base
    of the heart

    V3,V4 and V6: positive


    because the chest
    electrode are nearer
    to the apex
    ECG Leads
    ECG Leads
    Chest Leads
    Landmark: Angle of Louis
    Chest Leads represent the horizontal plane of the
    heart Position of chest leads:
    V1 - attached at the 4th •intercostal space, left parasternal
    border V2 – 4th intercostal space, right parasternal
    border
    V3 – located between V2 and V4
    V4 – 5th intercostal space, left midclavicular line (usually
    located below the nipple)
    V5 – left anterior axillary line, at the same level as V4
    V6 – same level as V4 and V5 but located at the mid axillary
    line Lead V4R - same level as V4 but located on
    Purpose of ECG
    Detects your heart's electrical rhythm and produces what's known as tracing.
    This tracing consists of representations of
    several waves that recur with each heartbeat.
    The wave pattern should have a consistent shape. If your waves are not
    consistent,
    or if they do not appear as standard waves, this is indicative of heart disease.

    Important diagnostic tool in the evaluation of CVD:


    Abnormal heart rhythm
    (arrhythmias) Myocardial
    ischemia/infarction Chamber
    enlargement
    Electrolyte abnormalities From : U . S . Food and Drug Administration
    CARDIAC CYCLE
    Cardiac Cycle: is the sequence of events (electrical and mechanical
    events taking place in the heart from the beginning of one
    heartbeat initiated by an impulse from the SA node.
    Electrical events: depolarization of the atria and depolarization and
    repolarization of the ventrile
    Mechanical events: contraction or relaxation of the
    atria and ventricles
    Examination Protocol
    Post Examination
    You should be able to go back to your normal diet and activities
    unless your doctor tells you differently.
    Generally, there is no special care after an
    electrocardiogram (ECG). Tell your doctor if you develop
    any signs or symptoms you had before the ECG (for example,
    chest pain, shortness of breath, dizziness, or fainting).
    When reading the ECG,
    look at the: Name
    Age
    Dat
    e
    Normal Electrical
    Conduction
    Pathway
    Normal Electrical
    Conduction
    Pathway
    Normal Electrical
    Conduction
    Pathway
    Conduction System of
    the Heart
    Inherent Rate
    Several cell types in the heart can generate rhythmic and repeated excitation
    pulses if required.
    Conduction System of
    the Heart
    ECG
    Waves
    ECG
    Waves
    ECG
    Waves
    ECG
    Waves
    ECG
    Waves
    ECG
    Waves
    Segments and Interval
    ECG/EKG Strip

    1 small box = 0.04


    sec

    1 big box = 0.20


    sec
    Method of EKG Interpretation

    1.Identify and examine


    the P wave
    2.Measure the PR interval
    3.Measure the QRS
    complex
    4.Identify the rhythm
    5.Determine the heart
    rate
    6.Interpret the strip
    Method of EKG Interpretation

    1.Identify and examine


    the P wave
    2.Measure the PR interval
    3.Measure the QRS
    complex
    4.Identify the rhythm
    5.Determine the heart
    rate
    6.Interpret the strip
    Method of EKG Interpretation
    Method of EKG Interpretation

    1.Identify and examine the P wave: present or absent


    2.Measure the PR interval: PRI = 0.12 - 0.20 sec
    3.Measure the QRS complex: QRS = 0.06 - 0.12 sec
    4.Identify the rhythm: regular or irregular
    5.Determine the heart rate: count the number of R
    in between x 10
    6.Interpret the strip
    ECG
    Waves
    ECG
    Waves
    ECG
    Rules
    Interpreting the Result
    The Tracing
    A tracing consists of repeated waves that have a standard
    shape. The waves have sections named
    the P wave, QRS complex, ST
    segment, and T wave.
    There is also a PR interval between the P wave and the QRS
    complex, and a QT interval between the QRS complex and the T
    wave.
    Standard
    Terminologies
    ECG
    Waves
    Interpreting the Result

    P wave - atrial depolarization


    QRS complex - ventricular
    depolarization T wave -
    ventricular repolarization
    Interpreting the Result
    Clinical
    Conditions
    Clinical
    Conditions
    Clinical
    Conditions
    References:

    Hybrid imaging in cardiovascular medicine, Liu, Yi-Hwa ;


    Sinusas, Albert J.
    (editor) The ESC textbook of cardiovascular imaging, 3rd ed.,
    Zamorano, Jose Luis et al.
    (editor)
    Cardiovascular imaging and image analysis, El-Baz, Ayman S.; Suri, Jasjit S
    (editor) The Johns Hopkins University, The Johns Hopkins Hospital, and Johns
    Hopkins Health System

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