1 Chapter Two

2 Electrocardiogram

2.1 Introduction

2.2 Electrocardiogram
As part of a routine check-up, if middle-aged or older. As a way of
evaluating symptoms that could be caused by heart problems, such as chest pain,
difficulty breathing, rapid or irregular heartbeat, or swelling in the legs, Is an
electrocardiogram performed? Circular sensors (electrodes) attached to the skin are
placed on the arms, legs and chest. Wires connected to the sensors are connected to
a device. When , the heartbeats, the sensors measure the electrical currents of the
heart,The device records the information received from each sensor and draws the
electrocardiogram squiggly line with bumps for the doctor to read.
Are there any side effects of an electrocardiogram .There are no side effects
of this examination, and it does not cause any harm at all during or after it. An
electrocardiogram helps a doctor learn many things about a person's heart, such as:
If you have had or are having a heart attack in the pastI ,f the patient has a heart
rhythm disturbance ,If the heart is not getting enough blood and oxygen If the
muscular wall of the heart is too thick ,If there are bulges in weak areas of the
walls of the heart (called an aneurysm . Are the electrical connections to the
device ?They are the electrodes or electrical sensors that are connected to wires
and connected to the device and are divided into the terminal connections that

1
connect to the four ends and the chest connections. The colors of the terminal
connections have been agreed upon as follows. The white colour , which is
connected to the right hand and written on it (RA). The black color, which is
connected to the left hand and written on it (LA) . The green colour, which is
attached to the right foot and is written on it (RL . The red color that connects to
the left foot and writes (LL) on it ,It is connected to the chest and its colour is
brown and written on it (c) In addition to the bipolar terminal connections
BIPOLAR . They are I, II, III and it is called EINTHOVEN TRIANGLE It is
connected as shown in (Fig 1)

As for the chest connections, they are divided into:

V 1 ,V 2 ,V 3 , V 4 , V 5 ,V 6

2
2.3 Scale and calibration of time
ECB play works electric heart structure on the recording of electrical
signals in your heart, It is a common and painful test, used to discover heart
problems and control your health quickly. Early heart capacity is being carried out
at the doctor's clinic or in a hospital room. ECB is standard equipment in operating
rooms and ambulances. Some personal devices, such as smartwatches, are also
available in the computer-cutting field. Ask your doctor if that's an option Why a
heart capacity is being conducted painful and impartially used to help diagnose
many of the problems of the heart of people of all ages. Your medicine may use a
special heart card planning to determine or discover:My abnormal heart
systems .carditis disorder If the cultivated or narrower in your heart the coronary
artery disease caused you Alma in the heart or a heart attack . whether you have
abducted a heart attack by the successful ice-risk treatments, such as the heartbeat
may be required to make a cardiac .
EcCE if you have any of the following indicators and symptoms . The pulse
of the pulse Dumping speed Diffuser The weight of the exercise does not
recommend the American heart Society using an ECA to evaluate the adult case
and do not have any symptoms and have risk rates have low. But if you have a
family history of heart disease, your doctor may propose a cardiac planning test as

3
testing, even though you do not feel any symptoms. If your symptoms tend to
appear and disappear, it may not pick up the heart card in the standard recording.
In this case, your doctor may recommend using the power-or-heart-wide network
organs. There are several different types of her.
Holter device. The Holler device is a small wearable device that recorded the
steady electrophilic chart continuously, usually for 24 to 48 hours. Monitoring of
heart attack events. This mobile device is similar to the Holter device, but it is only
recorded at certain times for a few minutes at a time. As you can wear it longer
than the Holter device, usually for 30 days. In general, you must click the button
when you feel symmetries. Some devices are automatically recorded at a time-out
of a ridiculous rhythm of the hearts. Risk The action of the heat capacity is a safe
action. There is no risk of electric shock during the test because the electrical
electrodes used do not produce electricity. Electrical electrodes recorded the
electrical activity in your heart only. You may feel slightly disturbed, such as the
disturbance you feel during the removal of the bandage when removing the
electrodes. Some people get a slight skin surface in the place of leisure leather. The
results may discuss your doctor with the results in the same day on which the heart
card is planned or on the next date. If the results of the heart card is a natural heart,
the f does not need to make more tests. If the results show the presence of a
heartfelt, you may need to make a cardiac card planning again or undergo other
diagnostic tests such as an echo scheme. The treatment method depends on the
cause of indicators and symptoms you show. Your doctor will record the
information recorded by the heart card planning and will search for any in-heart
problems, including * Heart of heartbeat. The heart rate can not be measured by
losing the pulse. Early heart planning can help if the feeling of mankind is difficult,
or the pulse was very fast or irregularly largely prevented its account accurately.
It can help the heart of your doctor in the identification of abnormal
heartbeat abnormal (heart acceleration) or inner dinars plunged (slow heart). *
Heart systems. An Early Cardiology Character Cardiac can disorder heart attacks (.
These cases may occur because of a bug in the functions of any part of the power
system of the heart. In other cases, some medications, such as beta, cocaine,
amphetamine, and cold and sensitive drugs available, can not be met to stimulate
heart attacks. * Cardiac. An early heart chart may show evidence of exposure to
the earlier heart and having a piece of bread in its beginning. The patterns that
appear on the heart card have indicated the heart to the damage in your heart and
the degree to which this damage has been reached. (Fig 3)

4
 Lack of heart supply blood and oxygen. Action cardiac cardio during the
symmetrical feeling can help your doctor to determine whether chest pain is about
the low blood flow of the heart attack, as with the chest pain due to unstable action.
Brownian distortions. The heart card show may show evidence of the heart or
walls, as well as the hearts of the heart and other problems. If your doctor finds any
problem in the heart of the heart you have made, you may be required to take
additional tests to determine whether the necessary treatment is necessary (Fig 4).

5
2.4 Normal voltage on the electrocardiogram
Electrocardiography or ECG records the electrical activity of the heart, as
the heart produces small electrical impulses that spread through the heart muscle
and cause contraction, and these impulses can be detected through the
electrocardiograph, and resort to The doctor usually performs an
electrocardiogram to help him find the cause of some symptoms such as
palpitations or chest pain, and sometimes this examination is done as part of
routine examinations, for example, before surgery. No damage or pain is caused
by the electrocardiogram test. Electrocardiogram (Fig 5)

6
 Electrocardiography in normal sinus rhythm .General information on types
of medical tests, tests and procedures for diagnosing heart diseases. The planning
is done with the patient lying on a comfortable table and completely relaxed. The
contact between the electrodes and the skin must be good and this is done by
applying a special ointment. The chart is done on chart paper, and the chart
reflects the electrical events that occur in the heart and all its parts. Electrodes
placed on different parts of the body detect electrical impulses coming from
different directions within the heart, and show normal diagrams for each
electrode.The ECG test is good, it can sometimes diagnose the heart problem
accurately, but the EKG cannot identify and diagnose all heart diseases, some
diseases cannot be detected by the electrocardiogram. Medicinal uses edit.
The general purpose of an electrocardiogram is to obtain information about
the electrical function of the heart. Medical uses for this information are varied
7
and often need to be combined with knowledge of the heart's structure and physical
examination signs to be interpreted. Some ECG indications include:Chest pain or
suspected myocardial infarction (heart attack), such as ST-segment elevation
myocardial infarction or non-ST-segment elevation myocardial
infarction.Symptoms such as shortness of breath, heart murmurs, fainting, seizures,
strange symptoms, or arrhythmias including new palpitations or observation of a
pre-existing arrhythmia.
Monitor drug effects eg, drug-induced QT prolongation, digoxin toxicity)
and manage overdose eg, tricyclic antidepressant overdosag. Electrolyte
disturbances, such as hyperkalemi. Perioperative monitoring in which any form of
anaesthesia is used eg, controlled anaesthetic care, general anaesthesia. This
includes preoperative evaluation and intraoperative and postoperative
monitoring.Cardiac stress test. Programmed tomography angiography and cardiac
magnetic resonance angiography (the ECG is used to "prime" the imaging process
so that the anatomical position of the heart is stable.Clinical electrophysiology of
the heart. A catheter is inserted through the femoral vein and may contain several
electrodes along its length to record the direction of electrical activity within the
heart. Electrocardiograms can be recorded for intermittent brief tracking or
continuous monitoring. Continuous monitoring is used for critically ill patients,
patients under general anaesthesia, and patients with arrhythmias that are difficult
to see on a traditional ten-second electrocardiogram. Continuous monitoring can
be performed using an electrical heart pressure monitor (Holter monitor),
defibrillators, internal and external artificial pacemakers, and/or telebiometrics.
[7][6] . Uses edit Having chest pai, In the event of an irregular heartbeat
Shortness of breath. Constant fatigue and stressHaving an abnormal heartbeat.
Diagnosis of some heart diseases Routine cardiac examination if there is a family
history Monitor the efficacy of heart medications
2.5 Generations of ECG devices
The means of quoting the heart signal have multiplied and evolved
significantly. They generally relied on ordinary galvanic scales in the beginning,
but did not provide the desired purpose, until transistors appeared and recorded on
paper and even process amplifiers, as these signals could be amplified and filtered
on the screens of the signal pars. With the advent of the computer, the mechanism
of the display, storage and processing developed, where it became possible to
compare several references and know the dysfunction more accurately. The latest
8
conclusion of science is to quote the heart signal by small mobile devices that the
patient puts in his pocket and they are in direct contact with him, where they store
the information first and show it and then transfer it to the computer if he wants.
(Fig 6 )

It is an electrical planning device carried in the pocket or can be worn on

the wrist, belt or shoulder strap, which records 24 hours to monitor the planning
during the practice of all daily activities and work to discover the relationship
between these activities and works and any change that may appear on the ECG
and be abnormal. The planning report is read after 24 hours using a computer,
which determines the presence of any difference in the pulse, an increase in the
heartbeat or the presence of abnormal blows, and then the patient is given
appropriate treatment either with medicines or by installing a pacemaker in the
event of a stop or impairment in the heart's electricity.( Fig 7)

9
10