心电图学Electrocardiography.pptVIP

医学资料 Electrocardiogram (ECG/EKG) Is a recording of electrical activity of heart conducted thru ions in body to surface Types of ECG Recordings Bipolar leads record voltage between electrodes placed on wrists legs (right leg is ground) Lead I records between right arm left arm Lead II: right arm left leg Lead III: left arm left leg Fig. 13.22b 3 distinct waves are produced during cardiac cycle P wave caused by atrial depolarization QRS complex caused by ventricular depolarization T wave results from ventricular repolarization Fig. 13.24b Fig. 13.24c Fig. 13.24d Fig. 13.24g Ischemic Heart Disease Is most commonly due to atherosclerosis in coronary arteries Ischemia occurs when blood supply to tissue is deficient Causes increased lactic acid from anaerobic metabolism Often accompanied by angina pectoris (chest pain) Ischemic Heart Disease Detectable by changes in S-T segment of ECG Myocardial infarction (MI) is a heart attack Diagnosed by high levels of creatine phosphate (CPK) lactate dehydrogenase (LDH) Arrhythmias Detected on ECG Arrhythmias are abnormal heart rhythms Heart rate 60/min is bradycardia; 100/min is tachycardia Arrhythmias Detected on ECG continued In flutter contraction rates can be 200-300/min In fibrillation contraction of myocardial cells is uncoordinated pumping ineffective Ventricular fibrillation is life-threatening Electrical defibrillation resynchronizes heart by depolarizing all cells at same time Arrhythmias Detected on ECG continued AV node block occur when node is damaged First–degree AV node block is when conduction through AV node 0.2 sec Causes long P-R interval Second-degree AV node block is when only 1 out of 2-4 atrial APs can pass to ventricles Causes P waves with no QRS In third-degree or complete AV node block no atrial activity passes to ventricles Ventricles driven slowly by bundle of His or Purkinjes Arrhythmias Detected on ECG continued AV node block occurs when node is damaged First–degree AV node block is when c