EKG

Suatu alat laboratoris  alat bantu diagnosis

EKG: rekaman aktivitas listrik jantung
pada permukaan tubuh
Normal Conduction System
EKG: MEMOTRET JANTUNG DARI SISI FRONTAL DAN
HORIZONTAL
Sandapan Dada Kanan
AVR +
+ IRAMA SINUS

III +
+ II
+
AVF
P Wave
 GELOMBANG P
Gambaran yang ditimbulkan oleh depolarisasi atrium

Normal
Tinggi : < 0,3 mvolt
Lebar : < 0,12 detik
Selalu positif di L II
Selalu negatif di aVR

Kepentingan
Mengetahui kelainan di Atrium
“Gelombang P Mitral”

“ Gelombang P Pulmonal “
P Pulmonale
P Mitral
PR Interval
 Interval PR
Diukur dari permulaan P s/d permulaan QRS

Normal : 0,12 - 0,20 detik

QRS Complex
 GELOMBANG QRS

Gambaran yang ditimbulkan oleh depolarisasi ventrikel

Normal :
Lebar : 0,06 - 0,12 detik
Tinggi : Tergantung lead

Normal gelombang Q
Lebar : < 0,04 detik
Dalam : < 1/3 tinggi R
ST Segment
T Wave
Anatomi Koroner dan EKG 12 sandapan

• Sandapan V1 dan V2 menghadap septal area ventrikel kiri

• Sandapan V3 dan V4 menghadap dinding anterior ventrikel kiri

• Sandapan V5 dan V6 ( ditambah I dan avL ) menghadap

dinding lateral ventrikel kiri

• Sandapan II, III dan avF menghadap dinding inferior ventrikel kiri
V1 – V4 anterior
Mid LAD occlusion
after the first septal
perforator ( arrow )

ECG :
Anterior MI
Occlusion of diagonal
branch ( arrow )

ST elevation in I and aVL

ECG, large Anterior Infarction
 Proximal large RCA occlusion

ST elevation in leads II, III, aVF, V5, and V6

with precordial ST depression
 Small inferior distal RCA occlusion

ECG changes in leads II, III, and aVF

AXIS
 Right Axis Deviation Left Axis Deviation

LAD

RAD
Normal Sinus Rhythm

Rhythm : Regular
Rate : 60 – 100
P wave : Normal in configuration; precede each QRS
PR : Normal ( 0. 12 – 0.20 seconds )
QRS : Normal ( less than 0.12 seconds )
First-degree AV block

Rhythm : Regular
Rate : Usually normal
P wave : Sinus P wave present; one P wave to each QRS
PR : Prolonged ( greater than 0.20 seconds )
QRS : Normal
Second -degree AV block, Mobitz I

Rhythm : Irregular
Rate : Usually slow but can be normal
P wave : Sinus P wave present;
some not followed by QRS complexes
PR : Progressively lengthens
QRS : Normal
Second-degree AV block, Mobitz II

Rhythm : Regular usually;

can be irreguler if conduction ratios vary
Rate : Usually slow
P wave : Two, three, or four P waves before each QRS
PR : PR interval of beat with QRS is constant;
PR interval may be normal or prolonged
QRS : Normal if block in His bundle;
wide if block involves bundle branches
Mobitz II
Third-degree AV block

Rhythm : Regular
Rate : 40 – 60 if block in His bundle;
30 – 40 if block involves bundle branches
P wave : Sinus P wave present; bear no relationship to QRS;
can be found hidden in QRS complexes and T waves
PR : Varies greatly
QRS : Normal if block in His bundle;
wide if block involves bundle branches
Atrioventricular dissociation secondary to TAVB
Mobitz I
0.04
Right Bundle Branch Block
Left Bundle Branch Block
Wolff-Parkinson-White syndrome
Wolff-Parkinson-White syndrome
Sistem Konduksi Jantung

ECTOPIC
FOCUS
Premature Atrial Contraction
(Atrial Ekstrasistole)
Premature Atrial Contraction
Premature Junctional Contraction
(Atrial Ekstrasistole)
Premature Junctional Contraction
Premature Ventricle Contraction
(Ventricle Ekstrasistole)
Premature Ventricular Contraction
(Ventricular Extrasystole)
• Premature Ventricular Contraction (PVC) / VES
 Multifocal / Multiform
 Frequent (> 5x/1’)
 Salvo
 Bigemini
 R on T
 Klasifikasi Takikardia
• Dengan QRS sempit
– Reguler
– Ireguler
• Dengan QRS lebar
– Reguler
– Ireguler
KETAHUI KLASIFIKASI
 Takikardia dengan QRS
sempit
– Dengan irama ireguler :
• Atrial fibrilasi (AF)
• Atrial flutter (Af) dengan varying block
• Atrial takikardi (AT) dengan varying block
– Dengan irama regular : SVT
• Atrial flutter (Af)
• Atrioventricular Reprocicating Tachycardia (AVRT)
• Atrioventricular Nodal Reentrant Tachycardia (AVNRT)
• AT
• Junctional Tachycardia (JT)
• Narrow complex Ventricle Tachycardia (VT)
Takikardia dengan QRS lebar

– VT
– Supraventrikular Takikardi (SVT) dengan
bundle branch block (BBB)
• Aberrancy
• Pre-existing BBB
– SVT dengan pre-eksitasi
Bacalah EKG berikut dengan lengkap;

 Irama : sinus / tidak sinus

 Frekwensi : kali / menit
 Aksis : normal / LAD ( bergeser ke kiri ) /
RAD ( bergeser ke kanan ) / Superior
 Gelombang P : normal / LAE ( P mitral ) / RAE ( P Pulmonal )
 Interval PR : normal / memendek / memanjang
 Lebar QRS : normal / melebar
 Morfologi QRS : normal / LVH / RVH / RBBB / LBBB / WPW
 Segmen ST : normal / depresi / elevasi ( ukuran dan letak )
 Gelombang T : normal / negatif ( letak )

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