E c g to continue
This presentation is the property of its rightful owner.
Sponsored Links
1 / 28

E C G to continue…. PowerPoint PPT Presentation


  • 72 Views
  • Uploaded on
  • Presentation posted in: General

E C G to continue…. Interval changes assessment. PR (PQ) interval. Normally .12 s - .20 s (that is 3 – 5 mm of horizontal distance) Shorter (e.g.) in preexcitation syndromes Longer (e.g.) in AV block of first degree Dependent of the frequency For 60 beats / s is around 0.45 s.

Download Presentation

E C G to continue….

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -

Presentation Transcript


E c g to continue

ECG to continue….


Interval changes assessment

Interval changes assessment


Pr pq interval

PR (PQ) interval

  • Normally .12 s - .20 s

  • (that is 3 – 5 mm of horizontal distance)

  • Shorter (e.g.) in preexcitation syndromes

  • Longer (e.g.) in AV block of first degree

  • Dependent of the frequency

  • For 60 beats / s is around 0.45 s

QT interval


Preexcitation syndromes

Preexcitation syndromes

Accessory signal pathway

Orientation of QRS complex vector depends on the direction of propagation of the signal

Sy Wolff-Parkinson-White

has “delta” wave

Sy Lown-Ganong-Levin (without “delta” wave)

Risk of supraventricular paroxysmal tachycardia


Type a type b

type A type B


Reentry tachyarrythmias

Reentry tachyarrythmias

Reentry in Wolff-Parkinson-White’s Syndrome

Accessorypathway

Ectopic atrial extrasystole

tachycardia

wave

Short PR


Av block

AV block

1-st degree: Long PR inteval

2-nd degree

type one

type two

3-rd degree: No connection between atria and ventriculi


Av block of 2 nd degree

AV block of 2-nd degree

Wenkebach’s periods

(Mobitz II)


Av block of 3 rd degree

AV block of 3-rd degree


Other causes of interval changes

Short PR interval

preexcitation sy,

sympathetic act.,

hypoK,

AV nodal rhythms from the beginning of it

Long PRinterval

AV block1-stdegree

parasympathetic act.,

hyperK,

IHD,

medicaments(e.g. beta blockers)

Short QT intervalDigitalis,

hyperCa

(hyperK – tallpointing T wave)

Long QT

hypertension, after MI

hypoCa,

(hypoK– U wave),

Congenital (risk of sudden death)

Other causes of interval changes


Qrs left ventricular overload

Sokolow’s index: R in (V5 or V6) + S inV1

> 35mm

Attention young slim individuals (heart as a voltage source is closer to the chest leads – bigger voltage on the leads without hypertrophy)

QRS – left ventricular overload

Left heart hypertrophy

physiological


Qrs right ventricular overload

QRS – right ventricular overload

Vertical electrical axis (> 100°)

in V1: R >= 7mm or qR (volume overload)

in avR: r > 4 mm

in V6: R smaller/equal S(volume overload)

Physiological Pressure overload Physiological Volume overload


Qrs right bbb

QRS - right BBB

  • Causes: Dilatation and/or overload of right heart, MI,

    sometimes“physiological”

  • QRS > 0,11 s

  • If complete, then R’(r’) wave is bigger then R(r ) in V1

  • Repolarization changes


Qrs left bbb

QRS – left BBB

  • Causes: IHD, hypertension,

    cardiomyopathy,

    valvular disease,

    unknown

  • QRS >0,11s (with complete block)

  • Discordant T! and discordant dinivelization of ST


Qrs q wave myocardial infarction

QRS – Q wave myocardial infarction

  • In the Q-wave MI, there is necrosis throughout the cardiac wall, while in the non-Q wave, necrosis affects the endocardial zone only.

  • Pathological Q-wave

    Appears in the first 0,04 s of QRS

    Appears in the leads where there should be no Q or overlays the normal R (r) (e.g. in V1 to V5) – absence of the R-wave

    Deeper then 2mm (6mm in III)

    Q > 0,25 R for I, II, avL, (avF)

    Q > 0,15 R forV1 to V6


Qrs q wave mi

QRS – Q wave MI

  • There is no Q-wave in the beginning, but so-called “Pardee’s”wave (elevation of ST+ negative T)

  • We imagine the (left) heart as pyramid to describe the MI location.

  • Anterior

  • Septal (right)

  • Lateral (left)

  • Inferior (down side at the apex)and it’s posterior extension (close to the base of the pyramid)


Combination of bbb and mi

Combination of BBB and MI


Qrs serious embolism fibrosis hydropericardium

QRS – serious embolism, fibrosis, hydropericardium


Beware some changes are result of lead displacement

Beware – some changes are result of lead displacement


  • Login