Electrocardiogram Flashcards by Loui Mojica

On September 20th 1786 he wrote “I had dissected and prepared a frog in the usual way and while I was attending to something else I laid it on a table on which stood an electrical machine at some distance from its conductor and was separated from it by a considerable space.

Luigi aloisio galvani

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On ___________________ he wrote “I had dissected and prepared a frog in the usual way and while I was attending to something else I laid it on a table on which stood an electrical machine at some distance from its conductor and was separated from it by a considerable space.

September 20th 1786

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Italian scientist realizes that electricity is associated with the heart beat.

Carlo Matteucci

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Irish scientist analyzes the electric pattern of frog’s heart.

M a r y

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Who credited for the invention of EKG

William Einthoven

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using the ______________, William Einthoven diagnoses some heart problem

string electrometer EKG

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the noble prize for physiology or medicine is given to for his work on EKG

William Einthoven

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defined and position of chest leads

AHA and Cardiac society of great Britain

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increased Wilson’s Unipolar lead voltage by 50% and made
Augmented leads

Goldberger

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A Dutch doctor and physiologist.
He invented the first
practical electrocardiogram and received the Nobel Prize in Medicine in 1924 for it

William einthoven

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has evolved into compact electro systems that often include computerized interpretation of the electrocardiogram.

Modern ECG machine

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Is a graphic recording of the electrical
activity of the heart

ECG or electrocardiogram

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ECG Converts the heart’s electrical activity into
lines called

Waveforms

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Can be seen on a monitor or printed out
paper

ECG or electrocardiogram

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measurement of ST-segment
depression in exercise stress testing.

J-60 point

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measurement of ST-segment elevation and
ST segment depression in most instances.

J point

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The reference level for measuring ______________________is not the
TP interval.

ST-segment
deviation (depression or elevation)

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The reference level for measuring ST-segment
deviation (depression or elevation) is not the
________________.

TP interval

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The correct reference level is the

PR segment

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This reference (PR segment) level is also called

Base level or isoelectric level

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THE WIRING DIAGRAM OF THE HEART

SA node fires.

Excitation spreads through atrial myocardium.

AV node fires.

Excitation spreads down AV bundle.

Purkinje fibers distribute excitation through ventricular myocardium.

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PURPOSE/IMPORTANCE ECG

❖verify these alterations in heart rhythm
❖provides information about the specific type
of heart disease
❖provides information about which region in
the heart is affected.

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REASON WHY ECG IS DONE

❖If the patient had heart disease in the past.
❖If the patient has a medical condition that predisposes to
heart disease, such as hypertension, diabetes, high
cholesterol, or inflammatory disease.
❖If the patient has other significant risk factors for cardiac
disease.
❖An ECG is also required prior to any type of heart surgery.

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INDICATIONS ECG

❖ heart arrhythmias
❖ conduction abnormalities
❖ Myocardial infarction
❖ CAD
❖ hypertrophic cardiomyopathy
❖ signs of congenital electrical abnormalities
❖ electrolyte imbalances
❖ congenital heart defects
❖ infections involving the heart

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is a safe test that does not cause health complications.

ECG

EXAMINATION PROTOCOL: Before the Examination

• No preparation required for taking ECG.

EXAMINATION PROTOCOL: During the Test

• Pre-Test- Once in position, a total of ten electrodes are attached with a sticky, but easy-to-remove adhesive. One electrode is placed on each arm and leg, and six on the chest.

How many electrode that are attached to the patient

EXAMINATION PROTOCOL: POST TEST- AFTER THE TEST the electrodes are removed

• There are no limitations on patient’s activity • Rarely, the adhesive can cause allergic reactions or rashes, which may not be obvious until about 24 hours after the test.

RESPONSIBILITIES OF ECG TECHNICIAN

1.The technicians should remind the patients to lie flat and relaxed as possible 2.Remind the patient not to wear jewelries/metal during ECG. 3.Check the machine for proper standardization. 4.Check if the machine is properly grounded. 5.The technicians should ensure correct placement of leads while taking ECG

ECG EQUIPMENT

ECG machine Electrodes LEAD WIRES OR CABLE CONNECTIONS (Clip and Snap) ECG paper

• Are applied at specific locations on the patient's chest wall and extremities to view the heart's electrical activity from different angles and planes

Electrodes

LEAD WIRES OR CABLE CONNECTIONS

Clip and snap

• is a graph paper used to measure rates of impulse formation and the duration of the electrical events that occur in the heart

ECG PAPER

• Made up of vertical and horizontal lines, which form large and small boxes

ECG PAPER

is a medical test that is recorded using leads, or nodes, attached to the body.

12-lead electrocardiogram (ECG)

sometimes referred to as ECGs, capture the electrical activity of the heart and transfer it to graphed paper.

12-lead electrocardiogram (ECG)

The ECG is made up of 12 characteristic views of the heart:

§ 6 from limb leads § 6 from chest leads

The ECG is made up of _____ characteristic views of the heart

6 LIMB LEAD

3 Bipolar limb leads 3 Unipolar Augmented leads

3 Bipolar limb leads

(Standard limb leads)- I, II, III

3 Unipolar Augmented leads

(aVR, aVL, aVF) Obtained through 4 electrodes placed on the RA,RL,LA,LL

6 CHEST LEADS has

V1,V2,V3,V4,V5,V6

Electrode positioned in the 4th intercostal space in the right sternal border

4th ICS in the left sternal border

Midway between V2 and V4

5th ICS in the left midclavicular line

Same level as V4, anterior axillary line

Same level as V4 and V5 ,midaxillary line

is the first positive deflection on the ECG

P wave

It represents atrial depolarization / contraction

P wave

Normal duration: P wave

< 0.12 s (< 120ms or 3 small squares)

In a sinus rhythm, there should be a P wave before each __________

QRS complex

Represents ventricular depolarization.

QRS complex

QRS COMPLEX Composed of 3 waves:

Q wave R wave S wave

is the first negative deflection.

Q wave

is the first positive deflection after the P wave.

R wave

is the negative deflection following R wave.

S wave

Measured from the beginning of P wave to the beginning of QRS complex.

PR interval

The normal PR interval is___________ sec, represented by 3-5 small squares.

0.12 - 0.2

The normal PR interval is 0.12 - 0.2 sec, represented by ________ small squares.

3-5

an isoelectric line representing early ventricular repolarization

ST segment

is the positive deflection after each QRS complex.

T wave

It represents ventricular repolarisation.

T wave

results from slow repolarization of ventricular Purkinje fibers

U wave

is a small (0.5 mm) deflection immediately following the T wave, usually in the same direction as the T wave.

U wave

represents total time required for ventricular depolarization & repolarization from the beginning of QRS complex to the end of T wave

QT segment

normal QT interval is

0.36 - 0.45 sec