Craig Ernst, MHS, PA-C. Rate Rhythm Axis Hypertrophy Infarct ST-T Changes (injury/ischemia) ...
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Transcript of Craig Ernst, MHS, PA-C. Rate Rhythm Axis Hypertrophy Infarct ST-T Changes (injury/ischemia) ...
![Page 1: Craig Ernst, MHS, PA-C. Rate Rhythm Axis Hypertrophy Infarct ST-T Changes (injury/ischemia) Intervals ◦ PR ◦ QRS ◦ QT.](https://reader033.fdocuments.us/reader033/viewer/2022061504/5697bf941a28abf838c90577/html5/thumbnails/1.jpg)
The ECGCraig Ernst, MHS, PA-C
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Rate Rhythm Axis Hypertrophy Infarct ST-T Changes (injury/ischemia) Intervals
◦ PR◦ QRS◦ QT
A Systematic Approach
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Quick Estimate◦“300, 150, 100, 75, 60, 50”
Alternative Methods◦6 second strip and multiply by 10
Or
◦1500/# mm between R-R
Rate
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What is the rate?
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What is the rate?
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P before each QRS?QRS follows each P?Regular or Irregular?
Rhythm
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What is the Rhythm?
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What is the Rhythm?
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What is the Rhythm?
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Leads I and AVF◦Upright in both = normal axis◦Up in I and down in AVF = LAD◦Down in I and up in AVF = RAD◦Down in both = Extreme RAD
Axis
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What is the Axis?
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What is the Axis?
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What is the Axis?
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S in V1 + R in V5 = greater than or equal to 35 mm
R in AVL greater than 11 mm
Hypertrophy (LVH)
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Q wave of greater than .04 sec (one small block)
Q wave 1/3 the amplitude or more of the QRS complex
Infarct
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Old Infarct? Where?
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Location of Infarct
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Injury◦ST elevation
Ischemia◦ST depression or T wave inversions
Location◦Same as for MI
ST-T Changes
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What is going on?
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PR duration: less than 0.12 or greater than 0.20
QRS duration: greater than 0.12QT duration: greater than 0.44
◦Should not be greater than half the R-R interval
Intervals
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RhythmsBlocks◦1st degree◦2nd degreeMobitz IMobitz II
◦3rd degree
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Name that Block
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Name that Block
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Name that block
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Ectopy◦PVC
◦PAC
Rhythms
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Rhythms
Tachycardias◦Sinus◦MAT◦PSVT◦A-fib◦A-flutter◦VT
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What is the Tachycardia?
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What is the Tachycardia?
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What is the Tachycardia?
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What is the Tachycardia?
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What is the Tachycardia?
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What is the Tachycardia?
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What is the Tachycardia?
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What is the Tachycardia?
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Potassium Calcium Drugs
◦ B-blockers◦ Calcium channel blockers◦ Digitalis
Effects of Drugs and Electrolytes
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Case