ecg interpretation zai1
TRANSCRIPT
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HOW TO READ
ELECTROCARDIOGRAPHY
SMF Kardiologi dan Kedokteran Vak!lar
RS"D Tan#!ng P!ra
Langkat
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STA$DARISASI EKG
Ke%e&atan kerta tandard EKG
25 mm / s (10 25 50 mm / s
Setia& kolo' (ori)ontal * +,+- e%
Setia& kolo' .ertikal /+ '' * / 'V
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PEMASA$GA$ ELEKTRODE
PEMASANGAN ELEKTRODE EXTREMITAS Lengan kanan an !engan k"#"
Kak" kanan an kak" k"#"
PEMASANGAN ELEKTRODE DADA $1 % Pa#as&e#na! kanan " I'S)
$2 % Pa#as&e#na! k"#" " I'S)
$) % M'L k"#" " I'S5
$* % Me"an an&a#a $2 gn $)
$5 % Pa#a A+"!!a"# L"ne k"#" " I'S5
$, % Me"an A+"!!a"# k"#" " I'S5
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SISTEMLEADS STANDARD LIM- LEADS
I. II. III
AGMENTED NIPOLAR LIM- LEADS a$R. a$L. a$
NIPOLAR 'EST LEADS $1. $2. $*. $). $5. $,
$*R. $)R. $5R. $,R
$. $3. $4
$R. $3R. $4R
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V7 V8V9 V9RV8RV7R
Horizontal plane ofV4-6
"ni&olar Pre%odial 6C(et7 Lead
Mervin J. Goldman, MD. 11thedition Principles of clinical Electrocardiography. Clinical Professor of Medicine University ofCalifornia School of Medicine San Francisco @199!19"#
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Conduction System
SA Node
Internodal branchAV NodeHiss BundlePurkinje FiberContraction
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The Electrocardioram ! EC" #
$ P %a&e ' atrialde(olarisation
$ )*S com(le+ '&entricularde(olarisation
$T %a&e ' &entricularre(olarisation
$ Atrial re(olarisationhidden by )*S
P
)
*
S
T
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ECG I$TERPRETATIO$
/, RHYTM
3, RATE
2, A8IS
-, HIPERTROPHIC SIG$S
1, MYOCARDIAL I$FARCTIO$0, ARRHYTHMIA
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/,RHYTHM
$or'al %ardia% r(5t(' 9 SI$"S r(5t('
Sin! r(5t(' %(ara%teriti% 9Rate 0+:/++ ;&'Contant R < R inter.al$egati.e P =a.e in aVR and &oiti.e di IIP =a.e i al=a5 >ollo=ed ;5 ?RS %o'&le4
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Normal Sinus Rhythm
*hythm ' *eular*ate ' ,- . /--P %a&e ' Normal in con0uration1 (recede each )*S
P* ' Normal ! -2 /3 . -23- seconds #)*S ' Normal ! less than -2/3 seconds #
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ME$GHIT"$G DE$Y"T @A$T"$G 9
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3, RATE
$or'al (eart rate 9 0+ < /++ 4'in!teB /++ 4'in!te 9 Sin! Ta%(5%ardia 0+ 4'in!te 9 Sin! radi%ardia
Deter'ination (eart rate 6nor'al &a&er &eed 31 ''79
2++
Co!nt n!';er o> large !are 6;old ;o4e in one R < R inter.al7
/1++
Co!nt n!';er o> 'all !are in one R < R inter.al
$!';er o> ?RS %o'&le4 in 0 e%ond '!lti&l5 ;5 /+
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ME$E$T"KA$ A8IS EKG
Meng(it!ng A4i9 S& 6ang "7a& 8!e9 &"ngg"n6a : ;8!&age R " I
engan : &"ngg"n6a ;8!&age R " a$
A+"s 6g n8#ma! 7e#aa an&a#a *0< gn =40& A+"s De; 7e#aa an&a#a *0< gn 40< R"g9& A+"s De; 7e#aa an&a#a =40< gn =130"n"s"kan se7aga" ak9"# k8m@!eks RS an @e#m!aan segmen ST
ent!k eg'en ST 9
up-sloping( &"ak s@es">"k
horizontal( !e7"9 s@es">"k n&k "skem"a down-sloping( @a!"ng &e#@e#Fa6a n&k "skem"a
Per!;a(an gelo';ang T@aa
"skem"a k#ang 7eg"& s@es">"k
Ge!8m7ang T 9"@e#ak&
kaang2 me#@akan sa&sa&n6a
@e#7a9an EKG 6ang &e#!"9a&
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Anato'i Koroner dan EKG /3 anda&an
Sana@an $1 an $2 meng9aa@ se@&a! a#ea ;en"ke! k"#"
Sana@an $* an $) meng9aa@ "n"ng an&e#"8# ;en"ke! k"#"
Sana@an $5 an $, ( "&am7a9 I an a;L meng9aa@
"n"ng !a&e#a! ;en"ke! k"#"
Sana@an II. III an a; meng9aa@ "n"ng "n>e#"8# ;en"ke! k"#"
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1, MYOCARDIAL I$FARCTIO$
IsF9em"a
In#6
NeF#8s"s
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A$TERIOR I$FARCTIO$
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I$FERIOR I$FARCTIO$
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POSTEROLATERAL I$FARCTIO$
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A%!te anteroe&tal '5o%ardial in>ar%tion,
H5&era%!te T:=a.e %(ange are noted
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A%!te anterolateral '5o%ardial in>ar%tion
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A%!te in>ero&oterior '5o%ardial in>ar%tion
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6 V H
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6 V H
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6 V H
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6 V H
* V
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* VH
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* V H
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* V H
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ARRHYTHMIA
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First-degree V !lo"#
*hythm ' *eular*ate ' 7sually normalP %a&e ' Sinus P %a&e (resent1 one P %a&e to each )P* ' Proloned ! reater than -23- seconds #
)*S ' Normal
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AV LOCK
Se"ond -degree V !lo"# %o!itz &
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Se"ond -degree V !lo"#$ %o!itz &
*hythm ' Irreular
*ate ' 7sually slo% but can be normalP %a&e ' Sinus P %a&e (resent1
some not 8ollo%ed by )*S com(le+esP* ' Proressi&ely lenthens)*S ' Normal
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Se"ond-degree V !lo"#$ %o!itz &&
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g
*hythm ' *eular usually1can be irreuler i8 conduction ratios &ary
*ate ' 7sually slo%P %a&e ' T%o9 three9 or 8our P %a&es be8ore each )*SP* ' P* inter&al o8 beat %ith )*S is constant1
P* inter&al may be normal or (roloned
)*S ' Normal i8 block in His bundle1%ide i8 block in&ol&es bundle branches
'hird-degree V !lo"#
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g
*hythm ' *eular*ate ' :- . ,- i8 block in His bundle1
;- . :- i8 block in&ol&es bundle branchesP %a&e ' Sinus P %a&e (resent1 bear no relationshi( to )* can be 8ound hidden in )*S com(le+es and T %a&P* ' Varies reatly
)*S ' Normal i8 block in His bundle1%ide i8 block in&ol&es bundle branches
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S@#a;en"F!a# &aF96Fa#"a
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?"e F8m@!e+ &aF96Fa#"a
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$en"F!a# >!&&e#
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