Professional Documents
Culture Documents
ECG Interpretation
ECG Interpretation
ELECTROCARDIOGRAPHY
ZULKARNAINI
Department of Cardiology and Vascular Medicine
Faculty of Medicine University of Indonesia
National Cardiovascular Center Harapan Kita
V6
V6R
V5R
V4R
V3R
V5
V4
V3
V2
V1
Mervin J. Goldman, MD. 11th edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of
California School of Medicine San Francisco @1995-1982
Horizontal plane of
V4-6
V7 V8 V9
V9RV8RV7R
Mervin J. Goldman, MD. 11th edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of
California School of Medicine San Francisco @1995-1982
The electrocardiogram
(ECG) illustrates
conduction of electrical
impulses in the heart.
The depolarization of the
ventricles occurs from
the endocardium
(inside) to the
epicardium (outside)
[e]
The repolarization of the
ventricles occurs in the
opposite direction. [g]
ECG INTERPRETATION
1.
2.
3.
4.
5.
6.
RATE
RHYTHM
AXIS
HIPERTROPHIC SIGNS
MYOCARDIAL INFARCTION
ARRHYTHMIA
1. RATE
Normal heart rate : 60 100 x/minutes
> 100 x/minutes : Sinus Tachycardia
< 60 x/minutes
: Sinus Bradicardia
300
Count number of large square (bold boxes in one R R interval)
1500
Count number of small square in one R R intervals
2. RHYTHM
Normal cardiac rhythm : SINUS rhythm
Sinus rhythm characteristics :
Rate 60-100 bpm
Constant R R interval
Negative P wave in aVR and positive di II
P wave is always followed by QRS complex
3. AXIS
4. HYPERTROPHIC SIGNS
5. MYOCARDIAL INFARCTION
Ischemia
Injury
Necrosis
ANTERIOR INFARCTION
INFERIOR INFARCTION
POSTEROLATERAL INFARCTION
ARRHYTHMIA
AV BLOCK
WHATS WRONG??
Lead Error: V1 and V3 are Transposed!
In this normal 12-lead ECG the V1 and V3 chest electrodes are
interchanged. Experienced ECG interpreters should be able to spot this
lead placement error.
DISCUSSION
Sinus arrhythmia
Early repolarization
Subendocardial ischemia.
Anterolateral ST-segment depression
Unstable angina
Mobitz I
Wolff-Parkinson-White syndrome
Wolff-Parkinson-White syndrome
Atrial fibrillation
Atrial flutter
Supraventricular tachycardia
Ventricular flutter
Idioventricular rhythm