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INTERPRETATION OF NORMAL ECG

No Procedure Interpretation
1 Patient identity MR.Broto, 35 y.O male
. name, age, gender , read clinical 4 nov 2008 09:47
history of patient if ade No clinical history of patient found
2 Placement of precordial leads Look for Lead II and aVR (for P wave)
. Lead II : +ve
aVR : -ve
Concl: OK and correct placement!!!
3 Placement of standard calibration 1o mm/mv = 10 small box/mv
. Concl: 1 small box =0.1 mv

4 Read standard paper speed 25 mm/sec25 boxes/sec


. Concl: 1 small box = o.o4 sec

5 Measure HR Atrial rate = 1500 /17 =88 bpm


. A.rate=1500/small box btwn PP interval Ventricle rate =1500/17 = 88bpm
=@@ 300/big box “ “ Concl: HR normal (range : 80-100bpm)
V.rate =1500/small box btwn RR
interval
=@@ 300/big box
6 Assess Regularity Atrial rate = ventricle rate (amik kertas dan tanda jarak antara PP or RR
. interval)
Concl: regular
7 Assess Rhythm • every P is followed by QRS
. • P +ve (upright) in Lead I,II,III
• PR interval more than o.12 sec (3 small box)
• every QRS is preceded by P wave
concl: Sinus rhythm

1 Assess P wave
. i. contour Smooth and monophasic in all lead Except in V1, V2 (biphasic)
NO notch foundconcl: Normal and no Left atrial enlargement
ii. morphology/configuration Upward in all lead, except aVR concl: Normal

iii. duration 3 small boxconcl: Normal (range : ≤3 small box)

iv. amplitude 2 small box concl: Normal (range : ≤2 small box)

Assessment of atrial enlargement assess P wave in lead II and V1

Concl: NO atrial enlargement!!


1 Measure PR interval 5 small boxconcl: Normal and no block (range: 3-5 small box)
.

2 Assess morphology Q wave • Present at V5 and V6 (Lead II and aVR: any size) and no Q wave
. in V1, V2, V3concl: No pathologic Q wave
• duration : 1 small box concl: Normal (range :≤ 1 small box)
• amplitude : less than 25 % of R waveConcl: Normal

1 Assess morphology R wave Amplitude getting larger from V1- V6


. Concl: Normal

2 Assess morphology S wave Amplitude getting smaller from V1- V6


. Concl: Normal

3 Measure R/S amplitude in V1 or V2 R/S amplitude in V1 less than 1 (smaller value divide larger value)
. Concl:Normal and no RV enlargement

Assessment of ventricle enlargement by using R/S ratio


tgk kt precordial V1, V2,V5,V6)
RV enlargement LV enlargement
1. R/S ratio at 1. sokolow Lyon criteria
V1 OR V2 > 1 RV5 OR V6 > 2.6 MV
V5 OR V6 < 1
(26 small box)
2. sokolow Lyon criteria RV5 OR V6 + SV1 >
R v1 +S V5 OR V6 ≥ 1.1 MV(11
3.5 MV (35 small
s.b)
box)
Concl:
1 Measure QRS
. i. duration 1 small boxconcl: Normal (range : 2-3 small box)

ii. maximal amplitude Limb lead : >5 small boxconcl: Normal (range > 5 small box)
Precordial : >10 small boxconcl: normal (range >15 small box)
iii. QRS axis Lead I : +ve
aVF : -ve
concl: Left axis deviation

1 Assess morphology ST segment No ST segment elevation or depression


. Isoelectric=parallel to PR segment (tandakan kt ECG paper)
Concl: Isoelectric and normal

2 Assess morphology T wave T wave amplitude


. Limb lead <5 small boxconcl: Normal
Precordial < 15 small boxconcl : Normal

3 Assess morphology U wave No U waveno hypokalemia concl : Normal


. (can see at V1 and V2)

4
. Measure QTc interval QTc = QT (in sec) / √ RR (in sec)
=
Concl : Normal (range male less than o.46, female less than 0.48)

FINAL CONCLUSION
 SINUS RHYTHM
 NO atrial enlargement
 normal axis
 left ventricle hyperthrophy
 others: within normal limit

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