EKG Interpretation.

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Presentation transcript:

EKG Interpretation

EKG Interpretation Sequence Regular or Irregular Rate P wave PR interval (normal 0.12-0.20) QRS (less than 0.12) ST segment T wave Ectopic beats

Regularity of the QRS complexes

Images: http://www.emergencyekg.com/graphics/Interactive_06.gif Heart rate (HR) 1500/small boxes= most precise HR calculation for regular rhythms Countdown method: 300 – 150 – 100 – 75 – 60 - 50 6 second method (irregular rhythms): Images: http://www.emergencyekg.com/graphics/Interactive_06.gif http://research.vet.upenn.edu/smallanimalcardiology/ECGTutorial/DeterminingHeartRate/tabid/4959/Default.aspx

Waveforms, Intervals, Segments, and Complexes (Lead II) P wave: PR interval: .12-.20sec >5 boxes for PR is heart block QRS complex: <.12sec ST segment: T wave: Ectopic Beats:

Sinus Tachycardia Sinus Bradycardia Regular rhythm Rate >100

Premature atrial contraction (PAC) Usually has regular underlying rhythm Early atrial contraction causes early P wave P wave usually abnormal in size, shape or direction and can be hidden in preceding T wave May initially have rate suppression after this beat

Premature atrial contraction (PAC)

Atrial Flutter Regular or irregular Rate: atrial 250-400, ventricular varies P waves: Sawtooth deflections

Atrial Fibrillation Irregularly irregular, difficult to assess with tachycardia Rate: Varies, Rapid Ventricular Rate (RVR) is > 100 bpm, Rate Control is < 100 bpm P waves: fibrillatory

Premature Ventricular Contraction (PVC) Underlying rhythm regular No P wave associated with the PVC Early wide QRS (>0.12) May be in sequence (ex: couplet, triplet, bigeminy, trigeminy)

Ventricular Tachycardia (VT) Regular rhythm Rate 140-250 No P wave associated with VT QRS wide (>0.12)

Ventricular Fibrillation No rhythm – P wave and QRS wave absent No rate Wavy irregular deflections of various sizes and shapes seen

Pacemakers Paced beat will have “pacer spike” on EKG Can be 100% paced If underlying rate is greater then pacer maker settings the pace maker will be inhibited and you will only see the underlying rhythm on EKG Can be mixed paced beats and native rhythm A-V paced (both atria and ventricle are paced, will have two pacer spikes per QRS)

Pacemakers

CASE STUDIES