MR. RAMAN LAL MR. RAMAN LAL PATIDARPATIDAR

LACTURER LACTURER SUMANDEEP SUMANDEEP VIDYAPEETHVIDYAPEETH

1842- Italian scientist Carlo Matteucci realizes that electricity is associated with the heart beat

1895 - William Einthoven , credited for the invention of EKG

1938 -AHA and Cardiac society of great Britan defined and position of chest leads

What is an EKG?What is an EKG?

The electrocardiogram (EKG) is a The electrocardiogram (EKG) is a representation of the electrical representation of the electrical events of the cardiac cycle.events of the cardiac cycle.

Each event has a distinctive Each event has a distinctive waveform waveform

The study of waveform can lead to The study of waveform can lead to greater insight into a patient’s greater insight into a patient’s cardiac pathophysiology.cardiac pathophysiology.

ECG is a permanent record of the electrical impulses generated in the heart by the depolarization and depolarization (contraction and relaxation) of the myocardium.

These impulses are transmitted to the surface of the body where they are detected and picked up by the electrodes and measured by the electrocardiograph.

When there are more P waves then QRS complexes, it indicates AV conduction block.

P wave is consider enlarged, if it is more than 3 small squares tall or 3 small squares wide, indicates of atrial enlargement.

1. Place the patient in a supine or semi-Fowler's position. If the patient cannot tolerate being flat, you can do the ECG in a more upright position.

2. Instruct the patient to place their arms down by their side and to relax their shoulders.

3. Make sure the patient's legs are uncrossed.

4. Remove any electrical devices, such as cell phones, away from the patient as they may interfere with the machine.

5. Causes of artifact: patient movement, loose/defective electrodes/apparatus, improper grounding.

HOW TO DO ELECTROCARDIOGRAPHY

An ECG with artifacts.

Patient, supine position

Place all theelectrodescorrectlyThese are

allelectrodes

The limb electrodes RA - On the right

arm, LA – On the left arm RL - On the right leg, LL- On the left leg

Precordial Leads

Arrangement of Leads on the EKG

Anatomic Groups(Septum)

Anatomic Groups(Anterior Wall)

Anatomic Groups(Lateral Wall)

Anatomic Groups(Inferior Wall)

Anatomic Groups(Summary)

1) A type of AV block characterised by progressive lengthening of the PR interval until the P wave fails to conduct is:A. Second degree AV-Block : Mobiz Type IIB. Second degree AV block: Mobiz Type IC. First degree  AV blockD. Third degree block

2)  Rhythms require permanent pacing in patients with cardiac disorders include:A. Supraventricular tachycardiaB. Second-degree Av block : Mobiz Type IC. Complete heart blockD. Wolf-Parkinson White  syndrome

3) A form of ventricular tachycardia usually occurs in the setting of QT prolongation is:

A. Monomorphic VTB.  Torsade de pointsC. Wolf-Parkinson White syndromeD. Sick sinus syndrome

4) A condition characterised by a prolonged PR interval more than 0.2 secs in ECG is called:

A. Second degree AV blockB. Mobiz Type II  AV blockC. First degree Av blockD. Complete block

5) Atrial depolarization is manifested on an EKG as _______.A.U wavesB.QRS complexC.T wavesD.P waves

1) B2) C3) B4) C5) D