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OVERVIEW
Cardiac Physiology
Electrocardiography Diagnosing Heart Conditions
Cardiac Physiology
Electrocardiography Diagnosis
ARTERIES
distributes blood from heart
VEINS
brings blood back to heart
Cardiac Physiology
Electrocardiography Diagnosis
Atria
Ventricles
Cardiac Physiology
Electrocardiography Diagnosis
Electrocardiography (EKG)
Prinsip Dasar EKG EKG Leads Interpretasi Basic EKG
Base
EKG + Depolarization Repolarization
Apex
(-)
Base
Major Electrical Axis
Apex
(+)
EKG Leads
The 12 EKG leads measure the electrical activity of the heart from 12 different directions Bipolar Leads: Lead I, Lead II, Lead III Unipolar Leads: aVR, aVL, aVF Precordial Leads: V1, V2, V3, V4, V5, V6
Leads
Precordial leads
Bipolar Leads -
Lead I
VII = VI + VIII
Right Arm -
Lead III +
Lead II +
Left Leg
Left Leg
aVL -
Right Arm
Left Arm
Left Leg
aVF
Left Leg
V6 Left Leg
Lead I
Lead II
V6
V4 V5
V1
V2
V3
Cardiac Physiology
Electrocardiography Diagnosis
Timing of ECG
EKG Waves
QRS Complex (Ventricular Depolarization)
P wave
EKG Intervals
P-R Interval = A-V Conduction Time Q-T Interval = Ventricular Contraction Time R-R Interval = Cardiac Cycle Time Heart Rate = 1/R-R Interval
QRS Complex
P wave
T wave
P wave
P-R Interval
Q-T Interval
Cardiac Physiology
Electrocardiography Diagnosis
R
P Q S T
Cardiac Physiology
Electrocardiography Diagnosis
R
P Q S T
Cardiac Physiology
Electrocardiography Diagnosis
R
P Q S T
1 sec
0.5 Sec
Graphic ECG
ECG Graphic
300/? =..bpm
Cardiac Physiology
Electrocardiography Diagnosis
R
P Q S T
Cardiac Physiology
Electrocardiography Diagnosis
R
P Q S T
Cardiac Physiology
Electrocardiography Diagnosis
R
P Q S T
1 sec
0.5 Sec
ECG Normal
Rhythm (Irama)
Sinus Arrythmia
Frequency
Normal Tachycardia Bradycardia
Arrythmia
SK
Arrhytmia
Tachyarrhythmia (rate >100 x/min)
QRS sempit (<0.12 ms) QRS lebar (>0.12 ms)
Duration of QRS
Regularity of QRS
P wave ??
P wave ?
Atrial Flutter :
-The result of a re-entry circuit within the atria -Irregular / regular QRS rate -Narrow QRS complex -Rapid P waves (300x/min), sawtooth
Atrial Flutter
PSVT :
-due to re-entry mechanism -narrow QRS complex -regular -retrograde atrial depolarization -P wave ?
SVT
SVT
Atrial Fibrillation :
-from multiple area of re-entry within atria -or from multiple ectopic foci -irregular, narrow QRS complex -very rapid atrial electrical activity (400-700 x/min). -no uniform atrial depolarization
Atrial Fibrillation :
-from multiple area of re-entry within atria -or from multiple ectopic foci -irregular, narrow QRS complex -very rapid atrial electrical activity (400-700 x/min). -no uniform atrial depolarization
Rapid AF
Junctional rhythm:
-AV junction can function as a pace maker
(40-60 x/min). -due to the failure of sinus node to initiate time impulse or conduction problem. -normal-looking QRS. -retrograde P wave. -P wave may preceede, coincide with, or follow the QRS
Cardiac Physiology
Electrocardiography Diagnosis
Preventricular Contractions
Coffee Cigarettes Sleep deprivation
Pathology
Cardiac Physiology
Electrocardiography Diagnosis
Normal ECG
SR
VES
VES
VES
SR
SR
SR
SR
SR
SR
Ventricular Tachycardia
VT
Ventricular Fibrillation
Cardiac Physiology
Electrocardiography Diagnosis
Normal ECG
Cardiac Physiology
Electrocardiography Diagnosis
Ventricular Fibrilation
Ischemia Electric Shock
AV conduction abnormalities 1st and 2nd AV Block Total AV Block BBB (Bundle Branch Block)
LBBB
VT
VF
A systole
Cardiac Physiology
Electrocardiography Diagnosis
Normal ECG
SUMMARY
Atria Ventricles Nodes Electrical Propagation
SUMMARY
ECG Measurement P-Wave QRS-Complex T-Wave
SUMMARY
AV Block PVCs V-Fib