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Pediatric EKG. Pediatric EKG. Arrhythmias CHD Ischemia/Infarction Miscellaneous (Drug, Electrolyte Abnormalities, …). Pediatric EKG. Screening Diagnosis Follow up. EKG Leads. Normal Values (Davignon). P wave. Atrial Depolarization Lead II Duration (≤3y max=0.09s, >3y max=0.1s)

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Pediatric ekg1
Pediatric EKG

  • Arrhythmias

  • CHD

  • Ischemia/Infarction

  • Miscellaneous (Drug, Electrolyte Abnormalities, …)


Pediatric ekg2
Pediatric EKG

  • Screening

  • Diagnosis

  • Follow up




P wave
P wave

  • Atrial Depolarization

  • Lead II

  • Duration (≤3y max=0.09s, >3y max=0.1s)

  • Amplitude (max=2.5mm)

  • Lead V1

  • Axis

  • Arrhythmias



Qrs complex
QRS Complex

  • Ventricular Depolarization

  • Duration (V5)

  • Amplitude (high, low if R+S ≤ 5mm for limb leads & ≤ 10mm for precordial leads)

  • Axis

  • Morphology (QRSR’)


T wave
T Wave

  • Ventricular repolarization

  • Amplitude ( high if ≥ 7mm in limb leads & ≥ 10mm in precordial leads )

  • Axis


T wave axis
T Wave Axis

  • I,II positive after 48 hours

  • aVf positive after 5 days

  • aVr negative

  • V3r, V1 negative (6 days to 6 years)

  • V6 positive





RVH

  • qR (V1)

  • Pure R (V1)

  • T wave abnormalities (V1)

  • R(V1) > P98

  • S(V6) > P98

  • R/S(V1) > P98

  • RSR’(V1)

  • RAD (after 3 years of age)


Rvh qr
RVHqR


Rvh pure r
RVHPure R


Rvh progressive t wave abnormalities
RVH Progressive T wave abnormalities


Rvh rsr 1year at least 15mm 1 year at least 10mm normal qrs duration
RVHRSR’<1year at least 15mm>1 year at least 10mmNormal QRS duration


LVH

  • ST segment & T wave abnormalities (I, II, aVf, V5, V6)

  • R(V6) > P98

  • S(V1) > P98

  • R(V6)+S(V1) > P98

  • Deep q (V6) (> 4mm)

  • LAD




BVH

  • Criteria for both RVH & LVH

  • RVH & normal forces of LV

  • LVH & normal forces of RV

  • R+S (mid-precordial leads) (Katz-Wachtel Index)


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BVH

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*


Atrial enlargement
Atrial Enlargement

  • Lead II (2.5×2.5)

  • Lead V1 (1×1)


RAE

  • Tall P wave

  • Large initial deflection (V1)


LAE

  • Broad P wave

  • Large terminal deflection (V1)



BAE

  • Both Criteria



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