Cardiovascular Medicine Book

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EKGAka: ECG, Electrocardiogram

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  1. See Also
    1. Electrocardiogram in Myocardial Infarction
    2. Electrocardiogram in Pulmonary Embolism
    3. Electrocardiogram in Pericarditis
    4. Electrocardiogram in Atrial Fibrillation
  2. Background
    1. Interpretation requires patient age, EKG indication
  3. EKG Paper
    1. Record speed: 25 mm/sec
    2. Small square (1 mm): 0.04 seconds
    3. Large square (5 mm): 0.20 seconds
  4. Leads
    1. Limb leads (bipolar)
      1. Lead I: Left arm - Right arm (0 degrees)
      2. Lead II: Left leg - Right arm (60 degrees)
      3. Lead III: Left leg - Left arm (120 degrees)
    2. Augmented Limb Leads (unipolar)
      1. Lead aVR: (-150 degrees)
      2. Lead aVL: (-30 degrees)
      3. Lead aVF: (90 degrees)
    3. Precordial Leads (unipolar chest)
      1. Lead V1: Right sternal border (Right Ventricle)
      2. Lead V2: Left sternal border
      3. Lead V3: Medial breast (Septum)
      4. Lead V4: Nipple
      5. Lead V5: Lateral breast
      6. Lead V6: Lateral chest wall (Left Ventricle)
  5. EKG Evaluation
    1. Assess EKG Validity
    2. Rate and Rhythm: "Watch your P's and Q's and the 3R's"
      1. Lead II P Waves upright? Otherwise not sinus rhythm
      2. QRS wide or narrow?
      3. Rate?
      4. Regularity of Rhythm?
      5. Relationship between P Waves and QRS Complex
    3. EKG Axis
    4. Intervals (prolonged?)
      1. PR interval
      2. QRS Complex
      3. QT Interval
    5. Hypertrophy?
      1. Left Ventricular Hypertrophy
      2. Right Ventricular Hypertrophy
      3. Right Atrial Enlargement
      4. Left Atrial Enlargement
    6. Infarction?
      1. Q Waves
      2. R Wave Progression
      3. ST Segments
      4. T Waves
    7. Reference
      1. Grauer (2001) 12 Lead EKGs, KG/EKG Press, Gainesville
  6. Specific Circumstances
    1. Ventricular Tachycardia
      1. Northwest axis (opposite Nl axis)
      2. V1-V6 positive QRS Complex
      3. See AV dissociation
    2. Pericarditis
      1. Stage I: Diffuse ST inc all leads except aVR, V1
      2. Stage II: ST segments temporarily normalize
      3. Stage III: Diffuse ST depress +/- T inversion
      4. Stage IV: Gradual normalization of ST and T Waves
    3. Pulmonary Embolism
      1. Right Strain Pattern (Classic PE, but rarely seen)
        1. S1 (deep S wave in lead I)
        2. Q3 (Q wave in lead III)
        3. T3 (inverted T Wave in lead III)

Electrocardiogram (C0013798)

ConceptsFinding (T033)
EnglishElectrocardiogram
CreditsDerived from the NIH UMLS (Unified Medical Language System)


Electrocardiography (C1623258)

Definition (MSH)Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
Definition (CSP)measurement and interpretation of electrical manifestations of heart activity.
Definition (NCI)A procedure which records the electrical current in the heart in the form of a continuous strip graph. The electrocardiography results may determine whether the heart is performing normally or suffering from abnormalities, may indicate coronary artery blockages, can be used for detecting calcium, magnesium and other electrolyte disturbances, allow the detection of conduction abnormalities, indicate the physical shape of a patient during stress test and provide information on the physical condition of the heart.
ConceptsDiagnostic Procedure (T060)
ICD989.52
EnglishECG, EKG, ELECTROCARDIOGR, Electrocardiogram, Electrocardiograph, Electrocardiographic procedure, Electrocardiography
SpanishECG, electrocardiograma, procedimiento electrocardiográfico, procedimiento electrocardiografico
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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