1. ELECTROCARDIOGRAM (ECG/EKG)

2. Outline Definition of ECG Electricity of the heart Indication of ECG
Understanding of ECG recording
Normal ECG

3. What is an electrocardiogram?
An electrocardiogram or 'ECG' records the electrical activity of the heart. The heart produces small electrical impulses which spread through the heart muscle to make the heart contract.

4. What is an electrocardiogram?
The ECG test is painless and harmless. (The ECG machine records electrical impulses coming from your body - it does not put any electricity into your body)

5. The electricity of the heart
The contraction of any muscle is associated with electrical changes called “depolarization” and these changes can be detected by electrodes attached to the surface of the body.

6. The electricity of the heart

7. Indications For diagnosis of:
Myocardial Infarction& other types of CAD such as angina
Cardiac dysrhythmias
Cardiac enlargement
Electrolyte disturbances
Inflammatory diseases of the heart
Effects on the heart by drugs, such as antiarrythmics

8. Understanding ECG recording
Each conventional ECG tracing records from :
Bipolar leads (2 opposite points) consisting of lead I, II, III
Unipolar leads i.e. aVR, aVL, aVF, V1, V2, V3, V4, V5 and V6.
Bipolar leads
All the bipolar leads measure the potential difference between 2 points namely :
lead I between right arm (RA) and the left arm (LA).
lead II between RA and left leg (LL).
lead III between LA and LL.

9. RIGHT ARM
LEFT ARM
LEFT LEG
RIGHT LEG
Limb leads

10. Chest leads V1:Electrode positioned in the 4th
intercostals space in the right sternal border.
V2: 4th ICS in the left sternal border.
V3: Midway between V2&V4.
V4: 5th ICS in the left midclavicular line.
V5: Same level as V4, anterior axillary line.
V6: Same level as V4 & V5, midaxillary line

11. Chest leads

12. V 1
V 2
Mid-Clavicular line
V 3
V 4
V 5
V 6

13. Nurse import ni
Mid-Clavicular line

14. Lead I
- Lead I + - -
Lead II
Lead II
Lead III +
Lead III +
Locations of standard lead I, II, III and chest leads for ECG recording

15. Normal ECG

16. The electrical activity of the cardiac cycle is characterized by five primary wave, designated by letters
P, Q, R, S, T.

17. Normal ECG P wave: Represents atrial contraction.
QRS complex: Represents ventricular depolarization (contraction)
T wave: Represents ventricular relaxation