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Electrocardiogram of the heart

What is an Electrocardiogram?

An electrocardiogram (ECG) or (EKG) is a test that records the electrical activity of the heart.

The electrodes of the machine pick up electricity comes out from our body due to heart muscle contraction.

The nerves to the heart create the electricity by charging during heart muscle contraction and discharging during muscle relaxation.

These electrical impulses are amplified and recorded in a paper.

How to prepare for ecg

Before the ECG, the medication history of the patient with heart attack or intake of any other drugs should be provided to the doctor to avoid misinterpretation of the results.

There is no restriction for the intake of for food and fluids.

But intake of cold water may change a wave called T wave.

The clothe and other jewels of the upper part of the body are removed which may interrupt the recording of electrocardiogram.

The patient is provided hospital gown to wear for convenience.

How to Record ECG of the Heart

The patient is asked to lie down over a cot.

The electrodes are fixed with suction cups and jelly to measure the heart impulse.

The electrodes are fixed over the chest, both hands and legs.

The results are recorded on graph paper

The recording of the heart taken after mild to moderate exercise is called as

heart stress test (stress ecg) or Tread Mill Test

Electrocardiogram reading is used to analyze....

  • The rate of heart
  • Normal and abnormal rhythm of heartbeats.
  • The size and enlargement of the heart.
  • Effects of drugs on the heart function.
  • Toxicity of certain drugs
  • Damage of the heart.
  • Function of a device on heart like pacemaker.
  • disease of the pericardium(covering layer of heart)
  • metabolic changes of the body which alters the recording.
  • Location of ischemia or infarction.
  • Other heart diseases.

Risk factors for Electrocardiogram

ECG is painless test.

Many patients refuse to do this test for the fear of pain and shock.

Hence there is no electricity is emitted from the machine itself. no chance for shock at all.

Very rarely patient may get skin allergies by putting the electrode disks over the skin.

12 Lead Electrocardiogram and Lead Placement

Leads Connections

Bipolar

Lead I Right arm-Left arm

Lead II Right arm-Left leg

Lead III Left arm-right leg

Unipolar

aVR Right arm

aVL Left arm

aVF Left foot

Chest Leads

V1,V2 V3 V4 V5 and V6

Interpretation of ECG

Normal ECG contains P,Q,R,S and T waves.

Irregular changes in these waves shows ischemic and infarction changes.

What is t waves and changes in Heart attack

T wave changes gives the clue for myocardial infarction.

T wave inversion shows the sign of infarction.

It is seen in the leads adjacent to the site of infarction.

Hyper acute elevation of t wave is seen in preceding ST segment elevation.

Area of infarction and ecg changes

ST segment elevation is seen in the leads adjacent to the site of infarction.

Leads II,III and aVF ------ Inferior(Lower) wall of the heart.

Leads V1,V2 and V3 ------ Anterior(Front) wall of the heart.

Leads V3 and V4 ------ Septal wall(the wall which divides the heart in the midline)

Other leads may show reciprocal ST segment depression.

Absence of Q waves indicates the higher risk for subsequent heart attack.




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