INTERPRETATION INTERPRETATION

- BASIC ECG - BASIC ECG

ANATOMI JANTUNGANATOMI JANTUNG

WHAT...APA ITU WHAT...APA ITU ECG?ECG?

ELECTROCARDIOGRAMELECTROCARDIOGRAM

Merakam tenaga elektrik Merakam tenaga elektrik yang dihasilkan oleh yang dihasilkan oleh jantungjantung

2 TYPE MYOCARDIAL CELL

1. Electrical cells :-1. Electrical cells :- * Pacemaker cells : specialize * Pacemaker cells : specialize

electrical cells, had ability to electrical cells, had ability to generate impulsegenerate impulse

* Conduction system* Conduction system

2. Myocardial ( Working ) Cells2. Myocardial ( Working ) Cells * Mechanical pump cells* Mechanical pump cells

ConductiveConductive system system of the heartof the heart

WAVE FORMWAVE FORM

NORMAL WAVENORMAL WAVE

PR INTERVAL

QRS COMPLEX

T WAVE

ST SEGMENT

STEP BY STEP ELECTRICAL STEP BY STEP ELECTRICAL ACTIVATION OF THE HEART ACTIVATION OF THE HEART

AND ECGAND ECG

ELECTRICAL ACTIVATION OF ELECTRICAL ACTIVATION OF THE HEART AND ECGTHE HEART AND ECG

A. SINUS IMPULSE ACTIVATES RTA. SINUS IMPULSE ACTIVATES RT

ATRIUM AND REACH THE NODESATRIUM AND REACH THE NODES

ELECTRICAL ACTIVATION OF ELECTRICAL ACTIVATION OF THE HEART AND ECGTHE HEART AND ECG

B. LT ATRIUM AND AV NODE HAVE B. LT ATRIUM AND AV NODE HAVE BEEN ACTIVATED AND P WAVE BEEN ACTIVATED AND P WAVE COMPLETED.COMPLETED.

ELECTRICAL ACTIVATION OF ELECTRICAL ACTIVATION OF THE HEART AND ECGTHE HEART AND ECG

C. PURKINJE SYSTEM IS ACTIVATED C. PURKINJE SYSTEM IS ACTIVATED

(A SILENT ECG EVENT )(A SILENT ECG EVENT )

ELECTRICAL ACTIVATION OF ELECTRICAL ACTIVATION OF THE HEART AND ECGTHE HEART AND ECG

D. WHEN THE SEPTUM ACTIVATED. WHEN THE SEPTUM ACTIVATE

ELECTRICAL ACTIVATION OF ELECTRICAL ACTIVATION OF THE HEART AND ECGTHE HEART AND ECG

E. MYOCARDIUM IS ACTIVATED FROM E. MYOCARDIUM IS ACTIVATED FROM THE ENDOCARDIUM TO THE THE ENDOCARDIUM TO THE

EPICARDIUM EPICARDIUM

ELECTRICAL ACTIVATION OF ELECTRICAL ACTIVATION OF THE HEART AND ECGTHE HEART AND ECG

F. ST SEGMENT AND THE T WAVE F. ST SEGMENT AND THE T WAVE

- MEANS VENTRICULAR- MEANS VENTRICULAR REPOLARIZATIONREPOLARIZATION

Depolarization :Depolarization : Electrical impulse Electrical impulse begin spreadbegin spread

Repolarization : Repolarization : Recovery phase Recovery phase will produce electric will produce electric changes ( action potential changes ( action potential of cells )of cells )

TerminologyTerminology

ECG PAPERECG PAPER

INTERPRETATION ECGINTERPRETATION ECG

How to start reading an ECG:How to start reading an ECG:1) Don’t panic!!1) Don’t panic!!2) check Name, Age and Date2) check Name, Age and Date3)Voltage (10mm/mV) and Speed Calibration(25 mm/sec) 3)Voltage (10mm/mV) and Speed Calibration(25 mm/sec) 4) aVR are all inverted…!!!4) aVR are all inverted…!!!

basic ECG:basic ECG:5) Rhythm5) Rhythm6) Rate= for regular 6) Rate= for regular 300 300 Number of big Squares Number of big Squares = = for irregular for irregular R PEAK TIMES 10.R PEAK TIMES 10.

FORMULA FOR CALCULATE HEART FORMULA FOR CALCULATE HEART RATE FOR REGULAR RHYTHMRATE FOR REGULAR RHYTHM

LARGE SQUARELARGE SQUARE RATE RATE

11 300300

22 150150

33 100100

44 7575

55 6060

66 5050

FORMULA FOR CALCULATE HEART FORMULA FOR CALCULATE HEART RATE FOR IRREGULAR RHYTHMRATE FOR IRREGULAR RHYTHM

1. COUNT THE NUMBER OF QRS 1. COUNT THE NUMBER OF QRS COMPLEXES WITHIN 6 SEC.COMPLEXES WITHIN 6 SEC.

MULTIPLY THE NUMBER BY 10.MULTIPLY THE NUMBER BY 10.

waves:waves:7) P wave ( not more than 2 small squares high and 2 7) P wave ( not more than 2 small squares high and 2 small squares wide) small squares wide)8) PR interval (not more than 5 small squares)8) PR interval (not more than 5 small squares)

9) 9) QRS complex: ( R wave progression from V1 to V6)QRS complex: ( R wave progression from V1 to V6) (width less than 3 small squares) (width less than 3 small squares)

Sekian terima kasih……..Sekian terima kasih……..

Atrial contraction

Vent. contraction

Vent. relaxation