Oleh :

Dr. Ida Bagus Aditya Nugraha

RSUD KABELOTA DONGGALA

2018
 Ventricular
Depolarization

Ventricular
Repolarization

Atrial
Depolarization

http://medstat.med.utah.edu
Name of patient
 Be systematic
 Put into the clinical context
Put into the
 Find an old ECG
clinical context
 Watch out for bad data
◦ Strive for good data
 Do NOT be afraid to get help
Name of patient

Important Clinical
Context Clues
 Be systematic
 Put into the clinical context
 Find an old ECG
 Watch out for bad data
Watch outdata
◦ Strive for good for bad
 Do NOT be afraid to get help
data
Name of patient

Important Clinical
Context Clues

Important “Bad Data” Clues

 BeBe Systematic
systematic
 Put into the clinical context
 Find an old ECG
 Watch out for bad data
◦ Strive for good data
 Do NOT be afraid to get help
 Be Systematic
 Rate: Fast-Normal-Slow
 Rhythm: Sinus, Blocks, Atrial,
Ventricular
 Axis: Normal, Right, Left
 Intervals and Durations
 Waveforms and Segments
(Morphology)
 Be Systematic
 Rate: Fast-Normal-Slow
 Rhythm: Sinus, Blocks, Atrial,
Ventricular
 Axis: Normal, Right, Left
 Intervals and Durations
 Waveforms and Segments
(Morphology)
 Be Systematic
 Rate: Fast-Normal-Slow

Rate – always the 1st Step!

Name of patient
1. Calculate Heart Rate
• 2 Basic Methods
3
0 1
1
0 5
0 0 7
0 5 6
0
Name of patient
1. Calculate Heart Rate
• “Big Box” Method
• # of QRS on ECG x 6

10 x 6 = 60 bpm

3 4 5 6 7 8 9 10
1 2
 Be Systematic
Rate: Fast-Normal-Slow
Rhythm: Sinus, Blocks, Atrial,
Ventricular
Rhythm – Sinus? Fast or Slow?
Regular or Irregular ?
 Be Systematic
 Rate: Fast-Normal-Slow
 Rhythm: Sinus, Blocks, Atrial,
Ventricular
Axis – Normal ? Right ? Left ?
 Axis: Normal, Right, Left
 RA&LA Left Axis
Extreme
Axis
+I/-AVF
-AVF

+I
RA
LA

Right Axis Normal

+AVF
-I/+AVF +I/+AVF Axis
 Be Systematic
 Rate: Fast-Normal-Slow
 Rhythm: Sinus, Blocks, Atrial,
Ventricular
 Axis: Normal, Right, Left
 Intervals and Durations
Intervals and Durations:
Short ? Long ?
 PR Interval
 QRS Duration
 QT Interval

PR interval QRS duration QT Interval

Normal: .12-.20 sec
Normal: .07-.10 sec Normal (corrected for rate
(3-5 small boxes)
or QTc): .440-.470 sec
 Be Systematic
 Rate: Fast-Normal-Slow
 Rhythm: Sinus, Blocks, Atrial,
Ventricular
 Axis: Normal, Right, Left
 Intervals and Durations
Waveforms and Segments
 Waveforms and Segments
(Morphology)
(Morphology)
 Inferior Myocardial Infarction

I aVR V1
aVR V4
I

aVL V2 V5
II
aVL
II aVF V3 V6
III

aVF
III
 aVR
I

aVL
II

aVF
III
 Be systematic
 Put into the clinical context
 Find an old ECG
 Watch out for bad data
◦ Strive for good data
 Do NOT be afraid to get help
SELAMAT
BELAJAR

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