Rapid Interpretation of EKG's PDF
Preview Rapid Interpretation of EKG's
RAPID INTERPRETATION OF EKG’s ay oo i HE Sua i TE Dale Dubin, MD RAPID INTERPRETATION OF EKG’s ... an interactive course by Dale Dubin, MD Table of Contents Chapter Page 1. Basie Principles 1 2. Recording the EKG a1 3, Autonomiie Nervous System 55 4. Rate 65 5. Rhythm, Part I: Arrhythmias of Focal Origin 97 Irregular Rhythms 107 Escape 12 Premature Beats, 122 ‘Tachy-arrhythmias 146 6. Rhythm, Part Il: Blocks 173 Sinus Block 74 IP AV Block 7 2° AV Block 179 3° AV Block 186 Bundle Branch Block 191 Hemiblock (see Chapter 9, Infarction) 7. Axis 203 8, Hypertrophy 164 243 9. Infaretion (includes Hemiblock) 259 Hemiblock . 295 10. Miscellaneous 309 Cardiae Monitor Displays 329 Personal Quick Reference Sheets (P QRS) 333 EKG Tracings 347 Index 364 Chapter 1: Basie Principles 1790, Galvani 10 1790, an aehence of usually sedate Scientists gesped in dshetiet as Luigi Galvan, lre af shossmaaship, made a dead iro’ eps cance by elecccal stimuli, “Galvani Knevr that completing a cirotit coanecting dissimilar sals to the legs of areceatly decessed fiog would create 4 simmating —eurrent ‘The resulting eleetical current would stimulate the thog’s legs 0 jump, and with repeated stimuli he could make them anes NH! Burin dhose Lanes, bringing a dead frog “back to life” ‘was a shosking and ghastly “supernatural” fet. (Ane Gatyant loved 1) * Got yoursell «warm cp of eos lax and ey ‘Be est is jus ay eas) ad emer, Captor Rosie Princes 18: 55, Kollicker and Mueller ‘While conducting base whe ator nerve @ arog ike! with exch heartbeat. ch around 1855. Kollicker and Muelier found et leg wa lsd over its inated beating hoa, the Te jareka!” taey thought, “the same electra stinnalus that causes a itog”s leg to kiek must cause the heart to bet So it was lngical fer the 2 assume that the beating ff the heurt must be due toa rhythmic discharge of stimuli electrical “NGL! And thus an association between he rhythmic pumping, ‘of the hezrt and electecal phenomena was seieutifically establ shel ‘Vary basie and very important. ‘CheperI: Basie Princsks Mid 1880's, Ludevig and Waller Inthe mic 1880's, while sing ¢ “capillary electzomtelr” Laig and Waller sliscovered Wat the ears rhythms eletrical stim cook be mired fom 4 poson’s skin ‘This aoparstus consisted of sensor elec'rodes that were placed fon trans and eonnerted to Lippman espillary skin s ectrometer, which used 2 capillary tube in an eloetic field tw datect faint electrical activity ‘The fluid level in Ue cayllary tube moved wits the rhythm of the subject's beat... very interesting, fheant ‘nis apparatus was Title 100 unsophisticated for clinical pplication, or even for economic exploitation, but it was interesting, | Nole This momentous achievement opened the dor for reonlirg the | heats eleticalactiviy from skin soracs. (Chapt I: Basie Pence Researcti by Dr. Willem ‘tinthoven aye mamet ‘nd nae Enter Br, Willem Einttover, a brant sicutst whe suspend a si betwean the poles of s magnet ‘Two skin seasors (electrodes) placed on a mn were den ceonneeto¢ to the ends of the slvered wire, which ran between the exo poles of the magnet ‘The silveroe {inthe magnetic Feld) wine ‘witehed to she rythm of the subject's hecrtbest, “This was also very interesting, Lut Eiathoven \wantec a timed recor 1901, Einthoven invents the EXG machine patent (7) ee, — cease \ trge magnet NS sod tne wre poo PKG recorsing So Biurhoven projected tay ight beam rough ho esi the magne's poles, aross the tvitchirg svered wits. Tbe wie's rhythmic movertents were recorded as waves (hat Le named P, QRS, andT) on a mowing sera of photogeanhie pape. ‘Very clever, that Binthoven! The -Sovements of the wire (tepreserting the heartbeat) ‘Sealed a bouncing shadow shythiie that ws recorded as a series rhythmic istinet waves in repeating Eyles ‘nursed the waves of each cycle (alphabetically) = QRS, and 1 Now,” thought the clever Finthoven, “we ean record a hearts coral eeetsical activity... ancl compare i to the norml.” And thus {rest ciagnostic too his “eleetrokardiogran.” (PleetreKardioGram), ved around 1501. Let's see how it works Cpe Is Basic Psat Tae eleetrocuringea record of eariae cletrcul ality, sh well ay valuable itormation abut the oats function and svete “The eloctrocarciogram is known by the three leer _ it provides us with a record of cardiac electrical activity and ‘vatable information about the beats function and structure “Nolet Since the time of Einthoven’s “eleetrokarciogram,” he medical profession has used the letters EKG 10 represent the electrocardiograsm, Some say that “ECG” is more comes ankl you may see itused in some texts, However, Mecicine honors tradition. ane! EKG has been used “or years, Also, ECG sounds ike FRG ite braia weve record'ng), and this an cause misunderstanding and contusion. ‘The BKG is inscribed on a ruled paper srig tat eves usa permanent cof candise activity and the health stats of the hear, Cardiac monitors and cardia telemetry provide the same information in real time. “KQ) eco ds he electrical activity of the Asa, providing EKG recerd Lett Ventrele ‘The EKG seoocds the eleesceal activity of eontaction ef fe hear muscle ‘myucurian ‘The :nformatien reconied on the EKG represen the heart's activity electrical ‘Most of the information on the FICG represents eleetrieal activity of ‘of the myowadium, ‘contraction |Naie! Tac EKC also yields valnable information about the Theut's ae ud iyi ‘When dhe myocardium (cardtwn: = heart, myo = muscle) is electicaly stimulated, it contracts “Note: Pais iLustration s intended to familiarize you with the simplifiad enoss-section ef the heart. The chambers are ent fied, and your shonlel knows Fem, for this disgram will he used! aften
The list of books you might like
