Upload
andi-rizki-ayu
View
117
Download
32
Embed Size (px)
Citation preview
DASAR-DASAR
INTERPRETASI EKG
Radityo Prakoso, Hary S Muliawan
Department of Cardiology and Vascular Medicine
Faculty of Medicine University of Indonesia
National Cardiovascular Center Harapan Kita
V6V5
V4
V3V2
V1
V6R
V5R
V4R
V3R
Midclavicular line
Anterior axillary line
Midaxillary line
Unipolar Precodial (Chest) Leads
Mervin J. Goldman, MD. 11th edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of California School of Medicine San Francisco @1995-1982
V7 V8 V9 V9RV8RV7R
Horizontal plane of V4-6
Unipolar Precodial (Chest) Leads
Mervin J. Goldman, MD. 11th edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of California School of Medicine San Francisco @1995-1982
ECG INTERPRETATION
1. RATE
2. RHYTHM
3. AXIS
4. HIPERTROPHIC SIGNS
5. MYOCARDIAL INFARCTION
6. ARRHYTHMIA
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
12
Gelombang P
3. AXIS
Determining Axis: An Example
4. HYPERTROPHIC SIGNS
Atrial Hypertrophy
Atrial Hypertrophy
P Pulmonale: Right (RAH)
P Mitrale: Left (LAH)
5. MYOCARDIAL INFARCTION
Ischemia
Injury
Necrosis
ANTERIOR INFARCTION
INFERIOR INFARCTION
POSTEROLATERAL INFARCTION
ARRHYTHMIA
Causes of Cardiac Arrhythmias
Disturbed automaticity : this may involved a speeding up or
slowing down of areas of automaticity such as the sinus
node, the atrioventricular (AV) node, or the myocardium.
Abnormal beats (depolarizations) may arise through this
mechanism from the atria, the AV junction, or the ventricles.
Disturbed conduction : conduction may be either too rapid (as
in Wolff- Parkinson-White syndrome) or too slow (as in AV
block)
Combinations of disturbed automaticity and disturbed
conduction
Sinus Rhythm
First Degree Heart Block
Second Degree Block Type I
*
Second Degree Block Type II
Third Degree Heart Block
Premature Atrial Contraction
*
Premature Ventricular
Contraction
Atrial Fibrillation
Atrial Flutter
Supraventricular Tachycardia
Ventricular Fibrillation
Ventricular Tachycardia
Torsade de Pointes
Bundle Branch Blocks
Characteristic QRS
pattern in lead I, V1,
and V6
Left Bundle Branch Block
*
Right Bundle Branch Block
*
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