MILESMILES

ECG FOR FAMILY PHYSICIANSECG FOR FAMILY PHYSICIANS

BYBY

DR.M.A.MERCHANTDR.M.A.MERCHANT

M.B.B.S., F.C.G.P., D.N.B.M.B.B.S., F.C.G.P., D.N.B.Lecture 1

Dr. K.P.MisraMy Guru

NEW ECG MACHINE

Galvanometer

EinthovenTriangle

Lead 1

Lead 2

Lead 3

Wilson Lead

Goldberg

Chest Leads

Standardization

STD-Over &Under Damp

ECG Paper

ECG PAPER –H.R.

Heart Rate

Normal ECG

Electrical Pathway

Impulse- QRS Patterns in Chest Leads

RelationshipOf the ECG

To The Cardiac

Conduction System

Direction of Waves

P Wave in V1

Progression of QRSFrom V1-V6

Normal Values

Causes of Low Voltage

1.Incorrect Standardization

2. Emphysema

3.Obesity or Thick chest

4. Pericardial Effusion or Constrictive Pericarditis

5. Myxoedema

6. Hypopituitarism

Normal Axis

Left Axis

Causes of Left Axis Deviation

1. Left Anterior Hemiblock

2. Inferior wall Myocardial Infarction

3. Emphysema

4. The Wolff-Parkinson-White Syndrome

5. An Apical Ectopic Ventricular Impulse

6. Apical Pacing

Right Axis

Causes Of Right Axis Deviation

1.Right Ventricular Hypotrophy2.Reversed arm electrodes3.Mirror image dextrocardia4.The Wolff-Parkinson –White

syndrome5.Left posterior hemiblock

HEXAAXIAL

Intermediate Position

Position of the Heart

Horizontal Position

Vertical Position

Frontal Plane

Horizontal Plane

Normal Rotation

CounterclockwiseRotation

Clockwise Rotation

RAH & LAH

LAH &

RAH

P-Wave in V1

RAH in V1

RAH

Causes of Right Atrial Enlargement

1. Pulmonary Hypertension

2. Cyanotic Congenital Heart Disease

3. Cor-Pulmonale

4. Tricuspid Stenosis

LAH in V1

LAH

Causes of Left Atrial Enlargement

1. Mitral Stenosis

2. Mass In the Left Atrium

3. Cardiomyopathy

Biatrial Hypertrophy

RVH-Diastolic Overload

RVH-Diastolic Overload-2

Causes of Right Ventricular Diastolic Overload

1.Atrial Septal Defect

2. Tricuspid Regurgitation

RVH-Systolic Overload-2

RVH-Systolic Overload

Causes of Right Ventricular Systolic Overload

1. Pulmonary Hypertension

2. Pulmonary Embolism

3. Pulmonary Stenosis

LVH –Diastolic overload

LVH-Diastolic Overload-2

LVH-Diastolic Overload-3

Causes of Left Ventricular Diastolic Overload

1.Mitral Regurgitaion

2. Aortic Regurgition

3.Ventricular Septal Defect

4.Patent Ductus Arteriosus

LVH-Systolic Overload

LVH –Systolic Overload-2

Causes Of Left Ventricuar Systolic Overload

1. Systemic Hypertension

2. Aortic Stenosis

3. Coarctation of Aorta

MILESMILES

ECG FOR FAMILY PHYSICIANSECG FOR FAMILY PHYSICIANS

BYBY

DR.M.A.MERCHANTDR.M.A.MERCHANT

M.B.B.S., F.C.G.P., D.N.B.M.B.B.S., F.C.G.P., D.N.B.

End of Lecture 1End of Lecture 1