Basics of ECG
Basics of ECG
![ecg ecg](https://4.bp.blogspot.com/-mK73ot1PZbE/WJgP4obTHFI/AAAAAAAAALo/zlnAtW51VTAi4uoiub5QLF30XoTmO_fiACLcB/s1600/ecg%2B1.png)
![qrs-wave qrs-morphology](https://3.bp.blogspot.com/-vm0O9GF554U/WJgW5S5MiBI/AAAAAAAAAMs/VV6n-Wms5Sk8rhAiwPGlkyqrUWl-Y09pgCLcB/s1600/QRS_patterns_ecg.gif)
Heart Rate [ Ventricular rate ]
Rhythm – Regular (same R-R intervals): 1500 / No. of small squares between 2 R- waves.
Rhythm – Irregular (different R-R intervals): No. of R- waves in 15 large squares × 20
Atrial Rate
In Total Heart Block, It Is Different From The Ventricular Rate
Atrial rate = 1500 / No. of small squares b/w 2 P- waves
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Axis deviation
Study I & III
Normal QRS complexes are predominantly upwards in both these leads
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Left Axis Deviation
![left-axis-deviation left-axis-deviation](https://1.bp.blogspot.com/-BtSnx7ZXLZI/WJgTsrtuYyI/AAAAAAAAAL8/FJj3994FyjEo4nWc1YXh0NmN_Cn82KzoACLcB/s1600/lad.png)
Left Axis Deviation– LVH, LBBB & inferior Wall infarct
Right Axis Deviation
![right-axis-deviation right-axis-deviation](https://3.bp.blogspot.com/-wAUcT3Mj_Lw/WJgT_HU5C2I/AAAAAAAAAMA/VAzx7zg9AjgFyqE6Wok0Z3Zc01LlEp3IACLcB/s1600/rad.png)
Right Axis Deviation- RVH, RBBB & anterior Wall infarct
“Left Leaves & Right Reaches”
ATRIAL HYPERTROPHY/ ENLARGEMENT
![arterial-enlargement arterial-enlargement](https://2.bp.blogspot.com/-RoQSooV1x5A/WJgUu8hYTXI/AAAAAAAAAMM/PQ8a3F7aD3Qvt1YVtQzTbwTeR_46iExkQCLcB/s1600/ah.png)
Contour Of P- Wave
Seen Best In II
P- Wave Represent Depolarisation Of Both Right & Left Atria. The SA Node Starts Depolarisation In Right Atrium So That Initial Part Of P- Wave Is Contributed By Right Atrium & The Later Part Of P- Wave Is Contributed By Left Atrium.
Left Atrial Enlargement: 2nd Part Is Delayed & Prominent, Wide (> 2.5 Small Squares) & Notched P- wave (since common in mitral valve diseases → P-mitrale )
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Right Atrial Enlargement: Initial Component Is Prominent: Tall (> 2.5 Small Squares) & Peaked P- wave (since common in pulmonary hypertension → P-pulmonale )
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BiLateral Atrial Enlargement : P- wave → taller > 2.5 small squares & wider > 2.5 small squares
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VENTRICULAR HYPERTROPHY
![ventricular-hypertrophy ventricular-hypertrophy](https://1.bp.blogspot.com/-rRPvSZ9HDgk/WJgWQ6OT8MI/AAAAAAAAAMk/h1-0dIdJIZ44CeQ1KA5DUqODt8es_MotgCLcB/s640/vh.png)
Diagnosed From Pattern And Amplitude Of QRS Complexes In The Chest Leads V₁ To V₆
Left Ventricular Hypertrophy
Pattern Normal
Amplitude Increases
Amplitude Of S- Wave In V₁ Or V₂ (Which Ever Is Larger) & Amplitude Of R- Wave In V₅ Or V₆ (Which Ever Is Larger)
SV₁ > 25 Mm
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RV₆ > 25mm
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SV₁ + RV₆ > 35mm
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Usually associated with LAD
May Be associated with P- Mitrale
Right Ventricular Hypertrophy
Pattern Changed
Prominent R- Wave In V₁ & Deep S- Wave In V₆
RV₁ > 7mm
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SV₆ > 7mm
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RV₁ + SV₆ > 10 Mm
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May Or May not associated with RAD
Often associated with P- Pulmonale
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