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TRANSCRIPT
HOW TO READ ELECTROCARDIOGRAPHY
Department of Internal MedicineFaculty of Medicine Chrisitan University of Indonesia
Kurniyanto, MD
ECG INTERPRETATION
1. RATE 2. RHYTHM 3. AXIS 4. HIPERTROPHIC SIGNS5. MYOCARDIAL INFARCTION6. ARRHYTHMIA
Pola Membaca EKG Irama Rate QRS Aksis QRS Morfologi Gelombang P Interval PR Durasi QRS Morfologi QRS Deviasi Segmen ST Morfologi Gelombang T Morfologi Gelombang U Lain-lain (LVH,LV
Strain,BBB, QT interval) Kesimpulan EKG
Nilai Normal :
Interval PR 0,12’’ s/d 0,20’’
Durasi QRS 0,04’’ s/d 0,12’’
Aksis Normal - 300 s/d + 1100
1. RATE
Normal heart rate : 60 – 100 x/minutes• > 100 x/minutes : Sinus Tachycardia• < 60 x/minutes : Sinus Bradicardia
Determination heart rate (normal paper speed 25 mm/s):
• 300
Count number of large square (bold boxes in one R – R’ interval)
• 1500
Count number of small square in one R – R’ intervals
• Number of QRS complex in 6 seconds, multiply by 10
2. RHYTHM
Normal cardiac rhythm : SINUS rhythm
Sinus rhythm characteristics :• Rate 60-100 bpm• Constant R – R’ interval• Negative P wave in aVR and positive di II• P wave is always followed by QRS complex
3. AXIS
4. HYPERTROPHIC SIGNS
5. MYOCARDIAL INFARCTION
Ischemia Injury Necrosis
ANTERIOR INFARCTION
INFERIOR INFARCTION
POSTEROLATERAL INFARCTION
ARRHYTHMIA
AV BLOCK
WHAT’S WRONG??Lead Error: V1 and V3 are Transposed!In this normal 12-lead ECG the V1 and V3 chest electrodes are interchanged. Experienced ECG interpreters should be able to spot this lead placement error.
DISCUSSION
Sinus arrhythmia
Limb lead reversal
Early repolarization
Subendocardial ischemia. Anterolateral ST-segment depression
Unstable angina
acute anterolateral myocardial infarction
High lateral infarction
Lateral myocardial infarction
Right ventricular infarction
Acute inferoposterior myocardial infarction
left ventricular aneurysm
Mobitz I
High-grade atrioventricular block
Wolff-Parkinson-White syndrome
Wolff-Parkinson-White syndrome
Atrial fibrillation
Atrial flutter
premature ventricular contraction
Supraventricular tachycardia
Wide complex tachycardia
Ventricular flutter
Idioventricular rhythm