DASAR-DASAR

INTERPRETASI EKG
Radityo Prakoso, Hary S Muliawan
Department of Cardiology and Vascular Medicine
Faculty of Medicine University of Indonesia
National Cardiovascular Center Harapan Kita
V
6
V
5
V
4
V
3
V
2
V
1
V
6R
V
5R
V
4R
V
3R
Midclavicular line
Anterior axillary line
Midaxillary line
Unipolar Precodial (Chest) Leads
Mervin J. Goldman, MD. 11
th
edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of
California School of Medicine San Francisco @1995-1982
V
7
V
8
V
9
V
9R
V
8R
V
7R
Horizontal plane of V
4-6
Unipolar Precodial (Chest) Leads
Mervin J. Goldman, MD. 11
th
edition Principles of clinical Electrocardiography. Clinical Professor of Medicine University of
California School of Medicine San Francisco @1995-1982
ECG INTERPRETATION
1. RATE
2. RHYTHM
3. AXIS
4. HIPERTROPHIC SIGNS
5. MYOCARDIAL INFARCTION
6. ARRHYTHMIA
1. RATE
Normal heart rate : 60 100 x/minutes
> 100 x/minutes : Sinus Tachycardia
< 60 x/minutes : Sinus Bradicardia
Determination heart rate (normal paper speed 25 mm/s):
300
Count number of large square (bold boxes in one R R interval)
1500
Count number of small square in one R R intervals
Number of QRS complex in 6 seconds, multiply by 10
2. RHYTHM
Normal cardiac rhythm : SINUS rhythm
Sinus rhythm characteristics :
Rate 60-100 bpm
Constant R R interval
Negative P wave in aVR and positive di II
P wave is always followed by QRS complex
12
Gelombang P
3. AXIS
Determining Axis: An Example
4. HYPERTROPHIC SIGNS
Atrial Hypertrophy
Atrial Hypertrophy
P Pulmonale: Right (RAH)
P Mitrale: Left (LAH)
5. MYOCARDIAL INFARCTION
Ischemia
Injury
Necrosis
ANTERIOR INFARCTION
INFERIOR INFARCTION
POSTEROLATERAL INFARCTION
ARRHYTHMIA
Causes of Cardiac Arrhythmias
Disturbedautomaticity :thismayinvolvedaspeedingupor
slowingdownofareasofautomaticitysuchasthesinus
node,theatrioventricular (AV)node,orthemyocardium.
Abnormalbeats(depolarizations)mayarisethroughthis
mechanismfromtheatria,theAVjunction,ortheventricles.
Disturbedconduction :conductionmaybeeithertoorapid(as
inWolff- Parkinson-Whitesyndrome)ortooslow(asinAV
block)
Combinations ofdisturbedautomaticityanddisturbed
conduction
Sinus Rhythm
First Degree Heart Block
Second Degree Block Type I
*
Second Degree Block Type II
Third Degree Heart Block
Premature Atrial Contraction
*
Premature Ventricular
Contraction
Atrial Fibrillation
Atrial Flutter
Supraventricular Tachycardia
Ventricular Fibrillation
Ventricular Tachycardia
Torsade de Pointes
Bundle Branch Blocks
Characteristic QRS
pattern in lead I, V1,
and V6
Left Bundle Branch Block
*
Right Bundle Branch Block
*
DISCUSSION
Sinus arrhythmia
Limb lead reversal
Early repolarization
Subendocardial ischemia.
Anterolateral ST-segment depression
Unstable angina
acute anterolateral myocardial infarction
High lateral infarction
Lateral myocardial infarction
Right ventricular infarction
Acute inferoposterior myocardial infarction
left ventricular aneurysm
Mobitz I
High-grade atrioventricular block
Wolff-Parkinson-White syndrome
Wolff-Parkinson-White syndrome
Atrial fibrillation
Atrial flutter
premature ventricular contraction
Supraventricular tachycardia
Wide complex tachycardia
Ventricular flutter
Idioventricular rhythm