Mod-1-Esentials of 12 LEAD

Views:
 
Category: Education
     
 

Presentation Description

No description available.

Comments

Presentation Transcript

:

Essential 12-Lead Interpretation MODULE 1

Essential 12-Lead ECG Interpretation:

Essential 12-Lead ECG Interpretation Goals Recognize and localize AMI on the ECG Feel comfortable with 12-lead interpretation

12-Lead ECG:

12-Lead ECG

12-Lead ECG:

12-Lead ECG

12-Lead ECG:

12-Lead ECG

12-Lead ECG:

12-Lead ECG

12-Lead ECG:

12-Lead ECG

12-lead ECG:

12-lead ECG

12-Lead ECG:

12-Lead ECG

R Wave:

R Wave

Q Wave:

Q Wave

S Wave:

S Wave

QRS:

QRS Q waves Physiologic Q waves < .04 sec (40ms) Pathologic Q > .04 sec (40 ms)

QRS:

QRS Q wave

QS Complex:

QS Complex

J-Point:

J-Point

ST Segment:

ST Segment

Practice:

Practice Find J-points and ST segments

Practice:

Practice Find J-points and ST segments

ST Segment :

ST Segment Compare to TP segment ST TP

ST Segment Analysis:

ST Segment Analysis

12-Lead ECG:

12-Lead ECG AMI recognition Two things to know What to look for Where you are looking

AMI Recognition:

AMI Recognition What to look for ST segment elevation One millimeter or more (one small box) Present in two anatomically contiguous leads

ST Segment Elevation:

ST Segment Elevation Presumptive evidence of AMI Indication for acute reperfusion therapy

Practice:

Practice

Lead “Views”:

Lead “Views”

Lead Groups:

Limb Leads Chest Leads I aVR V1 V4 II aVL V2 V5 III aVF V3 V6 Lead Groups

Lead “Views”:

Lead “Views”

Inferior Wall:

Inferior Wall II, III, aVF Left Leg I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

Inferior Wall:

Inferior Wall Inferior Wall I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

Lateral Wall:

Lateral Wall I and aVL Left Arm I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

Lateral Wall:

Lateral Wall V5 and V6 Left lateral chest I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

Lateral:

Lateral Lateral Wall I, aVL, V5, V6 I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

Anterior Wall:

Anterior Wall V3, V4 Left anterior chest I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

Anterior Wall:

Anterior Wall V3, V4 I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

Septal Wall:

Septal Wall V1, V2 Along sternal borders I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

Septal:

Septal V1,V2 I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

AMI Localization:

AMI Localization Anterior: V3, V4 Septal: V1, V2 Inferior: II, III, AVF Lateral: I, AVL, V5, V6 I II III aVR aVL aVF V1 V2 V3 V4 V5 V6

AMI Recognition:

AMI Recognition I Lateral II Inferior III Inferior aVR aVL Lateral V1 Septal aVF Inferior V2 Septal V3 Anterior V4 Anterior V5 Lateral V6 Lateral

AMI Recognition:

AMI Recognition Know what to look for ST elevation > 1mm Two contiguous leads Know where you are looking Use pocket card as a reference You will soon have this memorized

Practice:

Practice

Practice:

Practice

Evolution of AMI:

Evolution of AMI Hyperacute

Evolution of AMI:

Evolution of AMI Acute

Evolution of AMI:

Evolution of AMI Acute

Evolution of AMI:

Evolution of AMI Age undetermined

AMI Recognition:

AMI Recognition A normal 12-lead ECG DOES NOT rule out AMI

Practice:

Practice

Practice:

Practice

Practice:

Practice

Reciprocal Changes:

Reciprocal Changes

Reciprocal Changes:

Reciprocal Changes II, III, aVF I, aVL, V leads

Practice:

Practice

Practice:

Practice

AMI Recognition:

AMI Recognition Reciprocal changes Not necessary to presume infarction Strong confirming evidence when present

AMI Recognition:

AMI Recognition

AMI Recognition:

AMI Recognition Imitators of infarct LVH BBB Ventricular beats Pericarditis Early Repolarization Others

Summary:

Summary AMI recognition Know what you are looking for 1mm of ST elevation Two contiguous leads Know where you are looking Positive electrode as an “eye” Pocket card

Summary:

Summary Reciprocal changes Not necessary to presume infarction Strong confirming evidence when present

Summary:

Summary ST segment elevation is presumptive evidence for AMI Other conditions may also cause ST elevation

Summary:

Summary A normal 12-Lead ECG DOES NOT rule out AMI

ACS:

ACS AMI is part of a spectrum of disease know as the Acute Coronary Syndromes