The-ECG-in-Practice

This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions or ideas contained in the material herein. Part 2: The basics: the fundamentals of ECG recording, reporting and interpretation Before you can use the ECG as an aid to diagnosis or treatment, you have to understand the basics. Part 2 of this book explains why the electrical activity of the heart can be recorded as an ECG, and describes the significance of the 12 ECG 'leads' that make 'pictures' of the electrical activity seen from different directions. Part 2 also explains how the ECG can be used to measure the heart rate, to assess the speed of electrical conduction through different parts of the heart, and to determine the rhythm of the heart. The causes of common 'abnormal' ECG patterns are described. Part 4: Now test yourself You should now be able to recognize the common ECG patterns, and this final chapter contains twelve 12-lead ECGs from real patients for you to interpret. Quick reminders This has been placed at the back of the book after the index so you can refer to it quickly when you need to. It lists the common abnormalities you must be able to recognize. Further reading The symbol indicates cross-references to useful information in The ECG Made Practical, 7th edition (Elsevier, 2019). 'ECG' stands for electrocardiogram, or electrocardiograph. In some How to record an ECG? Electrodes are placed on the chest and limbs of the patient to record different views of the heart's electrical activity. Each view of the heart is described as a 'lead'. The word 'lead' does not refer to the electrodes. The rhythm of the heart can be determined from only one view, i.e. one lead (this requires two electrodes). For a full picture of the heart's electrical activity, a 12-lead view is conventional. One electrode is attached to each limb. These four electrodes provide six 'limb leads' or six different views of the heart in a vertical plane. These are called leads I, II, III, VL, VF and VR. VL, VF and VR used to be called AVL, AVF and AVR, respectively, but the A is essentially meaningless and is redundant. Six electrodes are attached to the chest, recording leads V 1 to V 6. Accurate placement of these electrodes is essential for comparing later ECGs. These leads 'look at' the heart from the front in a horizontal plane (Fig. 1.1). ECG abnormality Consider Ventricular rate above 120 bpm or below 45 bpm Ischaemia, hypotension, sepsis Atrial fibrillation Valve disease, alcoholism, ischaemia, infection Complete heart block Any heart disease ST segment elevation or depression Infarction, ischaemia Abnormal T wave inversion Infarction, ischaemia, pulmonary embolism Wide QRS width Any heart disease ■ TOP TIP: DON'T PANIC-THE ECG REALLY IS VERY EASY! Now you are ready to read the remainder of the book. 'ECG' stands for electrocardiogram, or electrocardiograph. In some countries, the abbreviation used is 'EKG'. Remember: FIG. 2.27 The effect of over-calibration Note Ventricular tachycardia, 74-75, 75f, 76f, 151f, 156f heart rate, diagnosis, 64-67 paroxysmal, 149 pulseless, shockable cardiac arrest, 160 supraventricular tachycardia vs., with bundle branch block, 75-77 torsade de pointes, 149, 151f Voltage changes, effect, 89 Voltage criteria, left ventricular hypertrophy, 89

Annals of Emergency Medicine, 1997

MAIN ELECTROCARDIOGRAPHIC CHANGES (Atena Editora), 2022

INTRODUCTION: The cardiac conduction system is formed by the sinoatrial (SA) node, interatrial and internodal bundles, atrioventricular (AV) node, bundle of His (atrioventricular) and Purkinje fibers. In the SA node, rhythmic impulses are generated that pass through the internodal pathways, reaching the AV node. In it, the impulse is conducted to the bundle of Hiss to finally reach the Purkinje fibers that will stimulate the entire cardiac ventricle. When evaluating an ECG, it is necessary to pay attention to both the way the stimulus is being conducted, that is, the morphology of the emitted waves, as well as the rhythm and frequency. METHODOLOGY: A systematic review of books on how to evaluate the ECG and its alterations was carried out, in addition to physiology treaties and guidelines on the same. This article aims to list the electrocardiographic changes in the main cardiac arrhythmias. RESULTS: Cardiac arrhythmia is a condition identified by abnormalities or lack of rhythm in the heartbeat. Monitoring systems capture a non-stationary physiological signal formed by a sequence of waves that reflect the electrical activity of the heart. In electrophysiology, the genesis of cardiac arrhythmias is related to changes in both the formation and conduction of the cardiac electrical impulse. Bradyarrhythmias are disturbances of the heart rhythm that accompany the decrease in HR and result either from the reduction in the generation of the electrical stimulus, or from the disturbance of conduction by the cardiac tissue. Tachyarrhythmias are defined when the HR is above 100bpm, whether sinus or not. CONCLUSION: The ECG is a practical and low-cost exam, being a complementary exam to the clinical history and exam in emergency rooms and outpatient consultations. Arrhythmias present peculiarities of the electrocardiographic tracings, being necessary to evaluate the same in order to choose the best therapeutic plan and prognosis for the patient.

International Journal of Research and Analytical Reviews (IJRAR) , 2023

in this paper we have know the Chapter - I Study of General Anatomy and Physiology of Human Heart • Introduction to the Human Heart • Position of Heart in Human Body • The Function of Heart Chapter - II • Types of Circulation • Structure of the Human Heart • Chambers of the Heart • Blood Vessels • Valves • The electricity of the heart Chapter - III ECG ( ELECTROCARDIOGRAM) • History of ECG. • Understanding the physiology • Formation of the ECG • ECG Leads • Normal Chest Lead ECG • Paediatric ECG • Determination of Electrical Axis • Abnormalities of qrs axis • Heart Rate • The rhythm of the heart • The ECG ‘Rule of Fours’ • 7 step approach to ECG rhythm analysis Chapter - IV ECG wave’s interval & segments. • P Wave  P Wave  Absent p wave  Inverted p wave  Changing p wave morphology  Tall p wave  Broad p wave • PR Interval • The Q Wave  Q waves in different leads  Pathological Q Waves  Differential Diagnosis  Loss of normal Q waves • The R Wave  R wave Overview  Abnormalities of the R wave  Dominant R wave in V1  Dominant R wave in aVR  Poor R wave progression • S Wave • QRS Complex • (J Wave) • T wave Overview • TP Segment • QT Interval • The ST Segment • U wave • Epsilon Wave Chapter - V • ECG Clinical Interpretation • Some cardiac diseases & terminology

2007

Abtract-This statement provides a concise list of diagnostic terms for ECG interpretation that can be shared by students, teachers, and readers of electrocardiography. This effort was motivated by the existence of multiple automated diagnostic code sets containing imprecise and overlapping terms. An intended outcome of this statement list is greater uniformity of ECG diagnosis and a resultant improvement in patient care. The lexicon includes primary diagnostic statements, secondary diagnostic statements, modifiers, and statements for the comparison of ECGs. This diagnostic lexicon should be reviewed and updated periodically. (J Am Coll Cardiol 2007;49:1128-35)