ELECTROCARDIOGRAPHY

Department of Cardiology and Vascular Medicine

Faculty of Medicine Chrisitan University of Indonesia
Nolly Rantung, MD
ECG INTERPRETATION
1. RATE
2. RHYTHM
3. AXIS
4. HIPERTROPHIC SIGNS
5. MYOCARDIAL INFARCTION
6. ARRHYTHMIA
 Pola Membaca EKG
Irama
Rate QRS
Aksis QRS
Morfologi Gelombang P
Interval PR
Durasi QRS
Morfologi QRS
Deviasi Segmen ST
Morfologi Gelombang T
Morfologi Gelombang U
Lain-lain (LVH,LV Strain,BBB,
QT interval) Nilai Normal :
Kesimpulan EKG Interval PR 0,12 s/d 0,20
Durasi QRS 0,04 s/d 0,12
Aksis Normal - 300 s/d + 1100
1. RATE
Normal heart rate : 60 100 x/minutes
> 100 x/minutes : Sinus Tachycardia
< 60 x/minutes : Sinus Bradicardia

Determination heart rate (normal paper speed 25 mm/s):

300
Count number of large square (bold boxes in one R R interval)
1500
Count number of small square in one R R intervals
Number of QRS complex in 6 seconds, multiply by 10
2. RHYTHM

Normal cardiac rhythm : SINUS rhythm

Sinus rhythm characteristics :

Rate 60-100 bpm
Constant R R interval
Negative P wave in aVR and positive di II
P wave is always followed by QRS complex
3. AXIS
4. HYPERTROPHIC SIGNS
5. MYOCARDIAL INFARCTION

Ischemia
Injury
Necrosis
ANTERIOR INFARCTION
INFERIOR INFARCTION
POSTEROLATERAL INFARCTION
P wave abnormalities
AV BLOCK
AV BLOCK derajat 2 tipe 1 dan
tipe 2
WHATS WRONG??
Lead Error: V1 and V3 are Transposed!
In this normal 12-lead ECG the V1 and V3 chest electrodes are
interchanged. Experienced ECG interpreters should be able to spot this
lead placement error.
Ventricular tachycardia
RBBB & LBBB
LBBB
Complete & incomplete
Complete
Sgarbossa criteria
Ves
DISCUSSION
Sinus arrhythmia
Limb lead reversal
Early repolarization
Anterolateral ST-segment depression
NSTEMI
acute anterolateral myocardial infarction
Acute inferoposterior myocardial infarction
Mobitz I
Wolff-Parkinson-White syndrome
Wolff-Parkinson-White syndrome
Atrial fibrillation
Atrial flutter
Supraventricular tachycardia
Wide complex tachycardia
Ventricular flutter
LBBB
Ventricular
tachycardia
Hiperkalemia (K=7.0)
RBBB
VES