ECG

Month 00, 2007

 The Heart

is a pump
has electrical activity
(action potentials)

generates electrical
current that can be measured
on the skin surface (the EKG)
 Cardiac Anatomy

Superior
vena cava

Pulmonary
veins Atrioventricular (AV) node
Sinoatrial (SA)A node Left atrium

Atrial muscle Mitral valve

Internodal
conducting
tissue
Tricuspid valve Purkinje
Ventricluar fibers
muscle
Inferior Descending aorta
vena cava
 Conduction in the Heart

0.12-0.2 s approx. 0.44 s

Superior
vena cava

SA Pulmonary
node veins AV node
SA node Left atrium

Atrial muscle Mitral valve

Atria
Specialized
AV
node conducting
tissue
Tricuspid valve Purkinje
Purkinje Ventricluar fibers
muscle
Ventricle Inferior Descending aorta
vena cava
Start of EKG Cycle
Early P Wave
Later in P Wave
Atrial depolarization, P-wave
Early QRS
Later in QRS
Ventricular depolarization, Q
Ventricular depolarization, R
Ventricular depolarization, S
S-T Segment
Early T Wave
Later in T-Wave
Ventricular repolarization, T
Back to where we started
ECG & dipole movement
 The Normal EKG

Right Arm “Lead II”

0.12-0.2 s approx. 0.44 s

PR QT

Left Leg
R

Atrial muscle T
depolarization P

Q S
Ventricular
Ventricular muscle
muscle
depolarization
repolarization
Lead II, normal ECG
Normal sinus rhythm, Lead II
Sinus tachycardia
Sinus bradycardia
Premature atrial contraction
SINUS BRADICARDIA
SINUS TACHYCARDIA
PREMATURE ATRIAL CONTRACTION
Not generated in the SA node
Not conducted in the SA node
Condition that increases vagal tone
CAD
MI
Digitalis and quinidine toxicity
Hypertensive diseases
Paroxysmal atrial tachycardia
Atrial flutter
Atrial fibrillation
ATRIAL FLUTTER
ATRIAL FLUTTER
Atrial fibrillation, lead II
 DISORDERS ARISING WITHIN THE
ATRIOVENTRICULAR JUNCTION

1.Disturbance in Automatcity
Junctional Rhythms
2.Disturbance in conduction
AV Block
HEART BLOCK-1ST DEGREE
HEART BLOCK-2ND DEGREE
HEART BLOCK-3rd DEGREE
Disorders arising in the ventricle
1.Disturbance in ventricular Automatcity
PVC
V-Tach
2.Disturbance in conduction
BBB
PREMATURE VENTRICULAR
CONTRACTION
BIGEMINY

TRIGEMINY
Ventricular tachycardia
Ventricular tachycardia, all leads
Ventricular fibrillation