Normal ST segment• Normal ST segment elevation: this occurs in leads with large S waves e.g., V1-3, and the normal configuration is concave upward.. ST segment elevation with conc
Trang 2Normal ST segment
• Normal ST segment
elevation: this occurs in
leads with large S waves
(e.g., V1-3), and the
normal configuration is
concave upward ST
segment elevation with
concave upward
appearance may also be
seen in other leads; this is
often called early
repolarization
Trang 3Abnormal ST segment
• Convex or straight
upward ST segment
elevation is abnormal and suggests transmural injury or infarction
Trang 4• 1 Rate
• 2 Rhythm and Blocks
• 3 Axis
• 4 Hypertrophy
• 5 Infarction
Trang 5• In NSR a resting heart rate of below 60 bpm is called bradycardia and a rate of above 90 bpm is called tachycardia
• Inherent rate of different ectopic foci:
– Atria 60-80/min
– AV junction 40-60/min
– Ventricles 20-40/min
Trang 6• 1 small box = 0.04 sec
• 1 big box = 0.2 sec or
1/300 min
• For bradycardia use the
“3 seconds” marks
• Count cycles in 6
seconds and multiply by
10
Trang 7• Site of origin
– sinus node, atria, AV junction, ventricles
• Rate relative to the "expected rate" for that pacemaker location
• Regularity
– Regular (e.g., PSVT)
– Regular irregularity (e.g., ventricular bigeminy)
– Irregular irregularity (e.g., atrial fibrillation or MAT) – Irregular (e.g., multifocal PVCs)
Trang 8Supraventricular arrhythmias
• Premature atrial complexes
• Premature junctional complexes
captures the atria (retrograde) and the ventricles (antegrade) The retrograde P wave may appear before, during, or
after the QRS complex; if before, the
PR interval is usually short
Trang 10Atrial Fibrillation
• Atrial activity is poorly defined; may see
course or fine undulations or no atrial
activity at all
• Ventricular response is irregularly
irregular and may be fast (HR >100
bpm, indicates inadequate rate control), moderate (HR = 60-100 bpm), or slow (HR <60 bpm, indicates excessive rate control, AV node disease, or drug
toxicity)