The electrocardiogram: Difference between revisions
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{{SI}} | {{SI}} | ||
{{CMG}}; '''Assistant Editor | {{CMG}}; '''Assistant Editor-in-Chief:''' [[User:Rim Halaby|Rim Halaby]] | ||
==Fundamentals of EKG== | ==Fundamentals of EKG== | ||
| Line 8: | Line 8: | ||
*[[Normal sinus rhythm]] | *[[Normal sinus rhythm]] | ||
*[[QRS axis and voltage]] | *[[QRS axis and voltage]] | ||
*[[Electrocardiography|Overall | *[[Electrocardiography|Overall overview on electrocardiography]] | ||
===EKG Complexes=== | ===EKG Complexes=== | ||
| Line 22: | Line 22: | ||
*[[ST interval|ST interval]] | *[[ST interval|ST interval]] | ||
===Abnormal Findings | ===Abnormal Findings on the EKG=== | ||
*[[Delta wave]] | |||
*[[H wave]] | |||
*[[K wave]] | |||
*[[Low QRS voltage]] | |||
*[[Nonspecific ST-segment and T-wave changes]] | |||
*[[NSSTW changes]] | |||
*[[Osborn wave]] | |||
*[[P wave alternans]] | *[[P wave alternans]] | ||
*[[ | *[[Poor R wave progression]] | ||
*[[PR interval alternans]] | *[[PR interval alternans]] | ||
*[[QRS complex alternans]] | *[[QRS complex alternans]] | ||
*[[ | *[[QT prolongation]] | ||
*[[ | *[[Retrograde P wave]] | ||
* [[Sine wave pattern]] | |||
*[[T wave alternans]] | *[[T wave alternans]] | ||
*[[T wave inversion]] | *[[T wave inversion]] | ||
*[[Tombstone ST elevation]] | *[[Tombstone ST elevation]] | ||
*[[U wave]] | *[[U wave]] | ||
==Conduction System== | ==Conduction System== | ||
*[[Cardiac pacemaker]] | *[[Cardiac pacemaker]] | ||
| Line 49: | Line 51: | ||
==Tachyarrhythmias== | ==Tachyarrhythmias== | ||
=== Atrial Arrhythmias === | === Atrial Arrhythmias === | ||
*[[ | *[[Atrial fibrillation electrocardiogram|Atrial fibrillation]] | ||
*[[ | *[[Atrial flutter electrocardiogram|Atrial flutter]] | ||
*[[Ectopic Atrial Rhythm]] | *[[Ectopic Atrial Rhythm|Ectopic atrial rhythm]] | ||
*[[ | *[[Multifocal Atrial Tachycardia (MAT)|Multifocal atrial tachycardia (MAT)]] | ||
*[[Paroxysmal Atrial Tachycardia (PAT) with Block]] | *[[Paroxysmal Atrial Tachycardia (PAT) with Block|Paroxysmal atrial tachycardia (PAT) with block]] | ||
*[[ | *[[Premature Atrial Contractions (PACs)|Premature atrial contractions (PAC)]] | ||
*[[ | *[[Sinus Tachycardia|Sinus tachycardia]] | ||
*[[ | *[[Supraventricular tachycardia electrocardiogram|Supraventricular tachycardia]] | ||
*[[Wandering atrial pacemaker]] | *[[Wandering atrial pacemaker]] | ||
=== Ventricular Arrhythmias === | === Ventricular Arrhythmias === | ||
*[[ | *[[Accelerated idioventricular rhythm electrocardiogram|Accelerated idioventricular rhythm]] | ||
*[[Ventricular fibrillation | *[[Ventricular fibrillation electrocardiogram|Ventricular fibrillation]] | ||
*[[Ventricular Parasystole|Ventricular parasystole]] | |||
*[[Ventricular tachycardia electrocardiogram|Ventricular tachycardia]] | |||
*[[Ventricular Parasystole]] | *[[Wide complex tachycardias]] | ||
*[[Ventricular | |||
*[[ | |||
==Bradycardia and Conduction Abnormalities== | ==Bradycardia and Conduction Abnormalities== | ||
*[[Sinus bradycardia]] | *[[Sinus bradycardia]] | ||
*[[First Degree AV Block]] | *[[First Degree AV Block|First degree AV block]] | ||
*[[Second Degree AV Block]] | *[[Second Degree AV Block|Second degree AV block]] | ||
*[[Complete or Third-Degree AV Block]] | *[[Complete or Third-Degree AV Block|Complete or third-degree AV block]] | ||
*[[Concealed conduction]] | *[[Concealed conduction]] | ||
*[[AV Junctional Rhythms]] | *[[AV Junctional Rhythms|AV junctional rhythms]] | ||
*[[Wolff-Parkinson-White | *[[Wolff-Parkinson-White syndrome EKG|Wolff-Parkinson-White syndrome]] | ||
*[[Left Bundle Branch Block]] | *[[Left Bundle Branch Block|Left bundle branch block]] | ||
**[[LAHB]] | **[[LAHB|Left anterior hemi-block]] | ||
**[[ | **[[Left posterior fascicular block electrocardiogram|Lefo posterior hemi-block]] | ||
*[[Right Bundle Branch Block]] | *[[Right Bundle Branch Block|Right bundle branch block]] | ||
*[[Trifascicular block]] | *[[Trifascicular block]] | ||
==EKG | ==EKG Findings in Diseases== | ||
===Cardiac Hypertrophy and Dilatation=== | ===Cardiac Hypertrophy and Dilatation=== | ||
*[[Electrocardiographic Findings in LVH| | *[[Electrocardiographic Findings in LVH|Left ventricular hypertrophy (LVH)]] | ||
*[[Electrocardiographic Findings in Right Ventricular Hypertrophy (RVH)]] | *[[Electrocardiographic Findings in Right Ventricular Hypertrophy (RVH)|Right ventricular hypertrophy (RVH)]] | ||
*[[Electrocardiographic Findings in Biventricular Hypertrophy]] | *[[Electrocardiographic Findings in Biventricular Hypertrophy|Biventricular hypertrophy]] | ||
*[[Electrocardiographic Findings in Left Atrial Enlargement]] | *[[Electrocardiographic Findings in Left Atrial Enlargement|Left atrial enlargement]] | ||
*[[Electrocardiographic Findings in Right Atrial Enlargement]] | *[[Electrocardiographic Findings in Right Atrial Enlargement|Right atrial enlargement]] | ||
*[[Electrocardiographic Findings in Biatrial Enlargement]] | *[[Electrocardiographic Findings in Biatrial Enlargement|Biatrial enlargement]] | ||
===Acute Myocardial Infarction=== | ===Acute Myocardial Infarction=== | ||
| Line 98: | Line 99: | ||
===Pre-excitation Syndromes=== | ===Pre-excitation Syndromes=== | ||
*[[Wolff-Parkinson-White | *[[Wolff-Parkinson-White syndrome]] | ||
*[[Lown Ganong Levine | *[[Lown-Ganong-Levine syndrome]] | ||
*[[Mahaim | *[[Mahaim type preexcitation]] | ||
===Cardiomyopathies=== | ===Cardiomyopathies=== | ||
*[[Arrhythmogenic | *[[Arrhythmogenic right ventricular dysplasia]] | ||
*[[Dilated | *[[Dilated cardiomyopathy]] | ||
*[[Hypertrophic | *[[Hypertrophic cardiomyopathy]] | ||
===Congenital Heart Diseases=== | ===Congenital Heart Diseases=== | ||
*[[Dextrocardia]] | *[[Dextrocardia electrocardiogram|Dextrocardia]] | ||
*[[ | *[[Atrial septal defect electrocardiogram|Atrial septal defect]] | ||
*[[Ventricular | *[[Ventricular septal defect electrocardiogram|Ventricular septal defect]] | ||
*[[Tetralogy of Fallot]] | *[[Tetralogy of fallot electrocardiogram|Tetralogy of Fallot]] | ||
*[[ | *[[The heart in conjoined twins]] | ||
*[[Congenital heart block]] | *[[Congenital heart block]] | ||
===Inherited Diseases=== | ===Inherited Diseases=== | ||
*[[Brugada | *[[Brugada syndrome]] | ||
===Other Heart Diseases=== | ===Other Heart Diseases=== | ||
*[[Pericarditis]] | *[[Pericarditis electrocardiogram|Pericarditis]] | ||
*[[Myocarditis]] | *[[Myocarditis electrocardiogram|Myocarditis]] | ||
*[[ | *[[Cardiac tamponade electrocardiogram|Cardiac tamponade]] | ||
*[[Sick | *[[Sick sinus syndrome electrocardiogram| Sick sinus syndrome]] | ||
*[[Long QT Syndrome]] | *[[Long QT Syndrome electrocradiogram|Long QT syndrome]] | ||
===EKG in | ===EKG in Other Disease States=== | ||
*[[EKG Abnormalities in CNS Disease]] | *[[EKG Abnormalities in CNS Disease|CNS disease]] | ||
*[[The EKG of Cardiac Transplantation| | *[[The EKG of Cardiac Transplantation|Cardiac transplantation]] | ||
*[[Electrocardiography of | *[[Electrocardiography of traumatic heart disease|Trauma]] | ||
*[[Hypothermia]] | *[[Hypothermia]] | ||
*[[Cardiac effects of insect bites]] | *[[Cardiac effects of insect bites|Insect bites]] | ||
==EKG Abnormalities in Electrolyte Disturbances== | |||
*[[Hyperkalemia electrocardiogram|Hyperkalemia]] | |||
*[[Hypokalemia electrocardiogram|Hypokalemia]] | |||
*[[Hypercalcemia electrocardiogram|Hypercalcemia]] | |||
*[[Hypocalcemia electrocardiogram|Hypocalcemia]] | |||
==EKG Abnormalities in Normal Pregnancy (Physiological Changes)== | |||
*[[QRS axis and voltage|Left axis deviation]] | |||
*[[QRS axis and voltage|Right axis deviation]] | |||
*[[Q wave|Q wave in lead III]] | |||
*[[T wave inversion]] | |||
*[[QRS complex|Increased R/S ratio in V1 and V2]] | |||
*[[ST interval|ST-segment depression]] (usually after anesthesia for C-section) | |||
==Drug Effects on the EKG== | ==Drug Effects on the EKG== | ||
*[[The EKG in the Patient Treated with Adenosine|Adenosine]] | |||
*[[The EKG in the Patient Treated with Amiodarone|Amiodarone]] | |||
*[[The EKG in the Patient Treated with Beta Blockers|β-blockers]] | |||
*[[The EKG in the Patient Treated with Bretylium|Bretylium]] | |||
*[[The EKG in the Patient Treated with Ca Channel Blockers|Calcium channel blockers]] | |||
*[[The EKG in the Patient Treated with Digitalis|Digitalis]] | *[[The EKG in the Patient Treated with Digitalis|Digitalis]] | ||
*[[The EKG in the Patient Treated with Disopyramide|Disopyramide]] | *[[The EKG in the Patient Treated with Disopyramide|Disopyramide]] | ||
*[[The EKG in the Patient Treated with Encainide, Flecainide and Propafenone|Encainide]] | |||
*[[The EKG in the Patient Treated with Encainide, Flecainide and Propafenone|Flecainide]] | |||
*[[The EKG in the Patient Treated with Lidocaine|Lidocaine]] | *[[The EKG in the Patient Treated with Lidocaine|Lidocaine]] | ||
*[[The EKG in the Patient Treated with | *[[The EKG in the Patient Treated with Lithium|Lithium]] | ||
*[[The EKG in the Patient Treated with Phenothiazines|Phenothiazines]] | |||
*[[The EKG in the Patient Treated with Phenytoin|Phenytoin]] | *[[The EKG in the Patient Treated with Phenytoin|Phenytoin]] | ||
*[[The EKG in the Patient Treated with | *[[The EKG in the Patient Treated with Procainamide|Procainamide]] | ||
*[[The EKG in the Patient Treated with | *[[The EKG in the Patient Treated with Encainide, Flecainide and Propafenone|Propafenone]] | ||
*[[The EKG in the Patient Treated with | *[[The EKG in the Patient Treated with Quinidine|Quinidine]] | ||
*[[The EKG in the Patient Treated with | *[[The EKG in the Patient Treated with Tocainide|Tocainide]] | ||
*[[The EKG in the Patient Treated with | *[[The EKG in the Patient Treated with Tricyclic Antidepressants|Tricyclic antidepressants]] | ||
*[[ | |||
*[[ | ==Technical Issues and Potential Errors in Interpretation== | ||
*[[The EKG in | *[[ECG artifacts|EKG Artifacts]] | ||
*[[EKG lead placement errors]] | |||
*[[The EKG in a patient with a pacemaker|EKG in a patient with a pacemaker]] | |||
*[[ | *[[EKG in athletes]] | ||
*[[ | *[[Persistent juvenile T-wave pattern]] | ||
*[[ | *[[Postprandial T Wave Changes|Postprandial EKG changes]] | ||
==Additional Information== | ==Additional Information== | ||
*[[History of the EKG]] | *[[History of the EKG]] | ||
*[[SCP-ECG]] | |||
*[[80 Lead ECG|80 lead ECG]] | |||
{{Electrocardiography}} | {{Electrocardiography}} | ||
Latest revision as of 15:35, 8 February 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor-in-Chief: Rim Halaby
Fundamentals of EKG
Basic Principles of Interpretation of an EKG
- Introduction to EKG
- How to read an EKG
- Normal sinus rhythm
- QRS axis and voltage
- Overall overview on electrocardiography
EKG Complexes
EKG Intervals
Abnormal Findings on the EKG
- Delta wave
- H wave
- K wave
- Low QRS voltage
- Nonspecific ST-segment and T-wave changes
- NSSTW changes
- Osborn wave
- P wave alternans
- Poor R wave progression
- PR interval alternans
- QRS complex alternans
- QT prolongation
- Retrograde P wave
- Sine wave pattern
- T wave alternans
- T wave inversion
- Tombstone ST elevation
- U wave
Conduction System
Tachyarrhythmias
Atrial Arrhythmias
- Atrial fibrillation
- Atrial flutter
- Ectopic atrial rhythm
- Multifocal atrial tachycardia (MAT)
- Paroxysmal atrial tachycardia (PAT) with block
- Premature atrial contractions (PAC)
- Sinus tachycardia
- Supraventricular tachycardia
- Wandering atrial pacemaker
Ventricular Arrhythmias
- Accelerated idioventricular rhythm
- Ventricular fibrillation
- Ventricular parasystole
- Ventricular tachycardia
- Wide complex tachycardias
Bradycardia and Conduction Abnormalities
- Sinus bradycardia
- First degree AV block
- Second degree AV block
- Complete or third-degree AV block
- Concealed conduction
- AV junctional rhythms
- Wolff-Parkinson-White syndrome
- Left bundle branch block
- Right bundle branch block
- Trifascicular block
EKG Findings in Diseases
Cardiac Hypertrophy and Dilatation
- Left ventricular hypertrophy (LVH)
- Right ventricular hypertrophy (RVH)
- Biventricular hypertrophy
- Left atrial enlargement
- Right atrial enlargement
- Biatrial enlargement
Acute Myocardial Infarction
Pre-excitation Syndromes
Cardiomyopathies
Congenital Heart Diseases
- Dextrocardia
- Atrial septal defect
- Ventricular septal defect
- Tetralogy of Fallot
- The heart in conjoined twins
- Congenital heart block
Inherited Diseases
Other Heart Diseases
EKG in Other Disease States
EKG Abnormalities in Electrolyte Disturbances
EKG Abnormalities in Normal Pregnancy (Physiological Changes)
- Left axis deviation
- Right axis deviation
- Q wave in lead III
- T wave inversion
- Increased R/S ratio in V1 and V2
- ST-segment depression (usually after anesthesia for C-section)
Drug Effects on the EKG
- Adenosine
- Amiodarone
- β-blockers
- Bretylium
- Calcium channel blockers
- Digitalis
- Disopyramide
- Encainide
- Flecainide
- Lidocaine
- Lithium
- Phenothiazines
- Phenytoin
- Procainamide
- Propafenone
- Quinidine
- Tocainide
- Tricyclic antidepressants
Technical Issues and Potential Errors in Interpretation
- EKG Artifacts
- EKG lead placement errors
- EKG in a patient with a pacemaker
- EKG in athletes
- Persistent juvenile T-wave pattern
- Postprandial EKG changes