How is ekg read

It is important to note that the rate at which a patient is labeled as having bradycardia is somewhat age dependent, and the rate should always be correlated with any new symptoms.

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Bhatia, MD, L. Yun, S. Munir, M. Gomez, MD A. An ECG is simply a representation of the electrical activity of the heart muscle as it changes with time, usually printed on paper for easier analysis. Like other muscles, cardiac muscle contracts in response to electrical depolarisation of the muscle cells. It is the sum of this electrical activity, when amplified and recorded for just a few seconds that we know as an ECG.

The normal cardiac cycle begins with spontaneous depolarisation of the sinus node, an area of specialised tissue situated in the high right atrium RA. A wave of electrical depolarisation then spreads through the RA and across the inter-atrial septum into the left atrium LA. The atria are separated from the ventricles by an electrically inert fibrous ring, so that in the normal heart the only route of transmission of electrical depolarisation from atria to ventricles is through the atrioventricular AV node.

The AV node delays the electrical signal for a short time, and then the wave of depolarisation spreads down the interventricular septum IVS , via the bundle of His and the right and left bundle branches, into the right RV and left LV ventricles. Hence with normal conduction the two ventricles contract simultaneously, which is important in maximising cardiac efficiency.

After complete depolarisation of the heart, the myocardium must then repolarise , before it can be ready to depolarise again for the next cardiac cycle. The wave of electrical depolarisation spreads from the atria down though the IVS to the ventricles.

So the direction of this depolarisation is usually from the superior to the inferior aspect of the heart. The direction of the wave of depolarisation is normally towards the left due to the leftward orientation of the heart in the chest and the greater muscle mass of the left ventricle than the right. This overall direction of travel of the electrical depolarisation through the heart is known as the electrical axis.

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Each clinical case scenario allows you to work through history taking, investigations, diagnosis and management. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! Table of Contents. This guide demonstrates how to read an ECG using a systematic approach.

If a patient has a regular heart rhythm their heart rate can be calculated using the following method:. As a result, you need to apply a different method:.

Mark out several consecutive R-R intervals on a piece of paper, then move them along the rhythm strip to check if the subsequent intervals are similar. If you are suspicious that there is some atrioventricular block AV block , map out the atrial rate and the ventricular rhythm separately i. As you move along the rhythm strip, you can then see if the PR interval changes , if QRS complexes are missing or if there is complete dissociation between the two. Cardiac axis describes the overall direction of electrical spread within the heart.