Complete Guide to ECG

Posted by e-Medical PPT Wednesday, October 20, 2010
Normal P waves
Height less than 2.5 mm in lead II
Width less than 0.11 s in lead II
Abnormal P waves see in right atrial hypertrophy, left atrial hypertrophy, atrial premature beat, hyperkalaemia

Normal PR interval
0.12 to 0.20 s (3 - 5 small squares)
Short PR segment consider Wolff-Parkinson-White syndrome or Lown-Ganong-Levine syndrome (other causes - Duchenne muscular dystrophy, type II glycogen storage disease (Pompe's), HOCM)
Long PR interval see first degree heart block and 'trifasicular' block

Normal QRS complex
Less than 0.12 s duration (3 small squares)
for abnormally wide QRS consider right or left bundle branch block, ventricular rhythm, hyperkalaemia, etc.
no pathological Q waves

Normal QT interval
Calculate the corrected QT interval (QTc) by dividing the QT interval by the square root of the preceeding R - R interval. Normal = 0.42 s.
Causes of long QT interval
Myocardial infarction, myocarditis, diffuse myocardial disease
Hypocalcaemia, hypothyrodism
Subarachnoid haemorrhage, intracerebral haemorrhage
Drugs (e.g. sotalol, amiodarone)
Hereditary - Romano Ward syndrome (autosomal dominant) ,Jervill + Lange Nielson syndrome (autosomal recessive) associated with sensorineural deafness

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