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Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Appendix D Basic 12-Lead Interpretation.

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Presentation on theme: "Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Appendix D Basic 12-Lead Interpretation."— Presentation transcript:

1 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Appendix D Basic 12-Lead Interpretation

2 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Myocardial Damage Caused by lack of oxygen to heart muscle  Ischemia: Initial insult  Injury: Damage caused by continued hypoxia  Infarction: Tissue death from prolonged hypoxia

3 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Infarction Location Inferior Lateral Anterior Surface II, III, aVF I, aVL, V 5, V 6 V 1, V 2, V 3, V 4 Facing Leads

4 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Infarction Location V 3 & V 4 V 2 & V 3 V1V1 These leads… Anterior wall of the left ventricle Anterior wall over the septum Anterior wall of the right ventricle Are directly over these surfaces

5 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Grades of Myocardial Damage

6 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Extent of Infarction

7 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Ischemic Changes

8 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Age of Infarction (Transmural MI)

9 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Infarction Location

10 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Anterior Wall Infarction (EKG)

11 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Anterior Wall Infarction (Surfaces)

12 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Lateral Wall Infarction (EKG)

13 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Lateral Wall Infarction (Surfaces)

14 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Inferior Wall Infarction (EKG)

15 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Inferior Wall Infarction (Surfaces)

16 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Atrial Enlargement

17 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Ventricular Enlargement

18 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Rule of 35

19 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Right Bundle Branch Block

20 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Left Bundle Branch Block

21 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

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27 EKG Abnormalities – P Waves Wide, flat P waves No P waves Abnormality Hyperkalemia Suggestive of

28 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ EKG Abnormalities – QRS Complexes Abnormality  Widening of QRS  Merging QRS and T Hyperkalemia Suggestive of  Widening of QRSHypokalemia  Prolonged QT intervalHypercalcemia  Short QT intervalHypocalcemia  Short QT intervalDigitalis Toxicity

29 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ EKG Abnormalities – ST Segments Abnormality  Disappearing ST segmentsHyperkalemia Suggestive of  ST depressionHypokalemia  Sloping ST segments  Depressed, “scooped” ST segments Digitalis Toxicity  Elevated, concave ST segmentsPericarditis

30 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ EKG Abnormalities – T Waves Abnormality  Tall, peaked T wavesHyperkalemia Suggestive of  Flattening of T waveHypokalemia  Diphasic or inverted T wavesDigitalis Toxicity

31 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ EKG Abnormalities – U Waves Abnormality  Development of U wavesHyperkalemia Suggestive of

32 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Analysis Format for 12-Lead EKG Interpretation

33 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ

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40 Miscellaneous Abnormalities, cont.

41 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Miscellaneous Abnormalities, cont.

42 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ Miscellaneous Abnormalities, cont.

43 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #1)

44 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #2)

45 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #3)

46 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #4)

47 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #5)

48 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #6)

49 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #7)

50 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #8)

51 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #9)

52 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #10)

53 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #11)

54 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #12)

55 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #13)

56 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #14)

57 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #15)

58 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #16)

59 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #17)

60 Gail Walraven, Basic Arrhythmias, Sixth Edition ©2006 by Pearson Education, Inc., Upper Saddle River, NJ 12-Lead EKG (Practice Tracing #18)


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