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1、ELECTROCARDIOGRAMThe Standard 12-lead ElectrocardiogramHow to measure each wave: amplitude duration25mm/sELECTROCARDIOGRAMECG records the changing potential of the field imparted by the heart.ECG dose not record directly the electrical activity of the heart.ECG record the electrical activity of the
2、heart from the body surface.插入离子通道图片Electrical basis and theoryElectrical basis and theorydepolarizationdipolerepolarizationElectrical basis and theoryElectrical basis and theoryqClinical electrocardiolopy elementary knowledgeVectorResultant vectorLoopElectrical basis and theoryThe Standard 12-lead
3、ElectrocardiogramSA nodeBachmannAV nodeHis bundleLeft and right branch of bundlePukinje fiberThe Standard 12-lead ElectrocardiogramP WaveP-R intervalQRS ComplexST segmentT WaveQ-T intervalThe Standard 12-lead ElectrocardiogramR Wave formLead System of the ECGLimb leads Einthoven trigoneHexaxial syst
4、emLead System of the ECGChest leads Chest leadsLead System of the ECG.ECG EVALUATION The Standard 12-lead ElectrocardiogramHow to measure each wave: amplitude duration25mm/sHow to calculate the heart rateHeart Rate = 60/R-R duration Mean QRS axisCardiac Rotation. NORMAL ECG P Wave P-R Interval QRS c
5、omplex J point ST Segment T Wave Q-T Interval U Wave. NOMAL ECGP Waveform：I、II、avF、V4-6 duration：0.12samplitude: Limb leads 0.25mV, Chest leads 2.5mV, RV5+SV13.5 or 4.0mV, RI1.5mV, R in aVL1.2mV, aVF2.0mV, S in V1 2.4mV, RI+SIII2.5mV.left axis deviation QRS duration0.09ms.ST segment and T wave left
6、Ventricular enlargmentAtrial and Ventricular hypertrophy(二） Right Ventricular enlargmentV1 lead R/S1, V5 lead R/S1.05mV. right axis deviation+90.ST-T change Right Ventricular enlargmentAtrial and Ventricular hypertrophy(三） Biventricular enlargementApproximately normal ECG.Left or Right Ventricular H
7、ypertrophy ECGBiventricular Hypertrophy ECGBiventricular enlargementV. Ischemia and ST-T SegmentForms:(1) Ischemia: a.subendocardial ischemia b.subepicardial ischemia (2) Injury. clinical significancedifferential diagnosisIschemia and ST-T SegmentIschemia and ST-T SegmentIschemia and ST-T SegmentIsc
8、hemia and ST-T SegmentVI. Myocardial Infarction(一）Forms and mechanism(1 ) ischemia(2 ) infury(3 ）infarctionVI. Myocardial InfarctionVI. Myocardial InfarctionVI. Myocardial InfarctionVI. Myocardial Infarction（二）Evolution of the infarction and duration the ECG(1 ) initial phase(2 ) acute phase(3 ) subacute phase(4 ) recovery phaseMyocardial InfarctionVI. Myocardial InfarctionThe ECG and location of infarctionMyocardial InfarctionMyocardial InfarctionNonspesific patterns of infarctionnon-Q wave myocardial infarctioninfarction complicated with other diseasesdifferential diagnosis
