1、ELECTROCARDIOGRAM,The First Affiliated Hospital of Shantou University Medical College 卢成志,The Standard 12-lead Electrocardiogram,How to measure each wave: amplitude duration,25mm/s,ELECTROCARDIOGRAM,ECG records the changing potential of the field imparted by the heart. ECG dose not record directly t
2、he electrical activity of the heart. ECG record the electrical activity of the heart from the body surface.,插入离子通道图片,Electrical basis and theory,Electrical basis and theory,depolarization dipole repolarization,Electrical basis and theory,Electrical basis and theory,q,Clinical electrocardiolopy eleme
3、ntary knowledge,Vector Resultant vector Loop,Electrical basis and theory,The Standard 12-lead Electrocardiogram,SA node Bachmann AV node His bundle Left and right branch of bundle Pukinje fiber,The Standard 12-lead Electrocardiogram,P Wave P-R interval QRS Complex ST segment T Wave Q-T interval,The
4、Standard 12-lead Electrocardiogram R Wave form,Lead System of the ECG,Limb leads,Einthoven trigone,Hexaxial system,Lead System of the ECG,Chest leads,Chest leads,Lead System of the ECG,.ECG EVALUATION,The Standard 12-lead Electrocardiogram,How to measure each wave: amplitude duration,25mm/s,How to c
5、alculate the heart rate,Heart Rate = 60/R-R duration,Mean QRS axis,Cardiac Rotation,. NORMAL ECG, P Wave P-R Interval QRS complex J point ST Segment T Wave Q-T Interval U Wave,. NOMAL ECG P Wave,form：I、II、avF、V4-6 duration：0.12s amplitude: Limb leads 0.25mV, Chest leads 0.20mV.,. NOMAL ECG P-R Inter
6、val,duration：0.12s0.20s.,. NOMAL ECG QRS complex,duration: 0.060.10s.form and amplitude.R peak timeQ Wave,. NOMAL ECG,J point ST Segment,T Wave Q-T Interval U Wave,IV. The Abnormal ECG,Atrial and Ventricular hypertrophy,Atrial and Ventricular hypertrophy (一）atrial enlargment,Left atrial enlargement,
7、Right atrial enlargement:,Atrial and Ventricular hypertrophy (一） left Ventricular enlargment,QRS voltage: R in V5,62.5mV, 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 Ventricular enlargment,Atri
8、al and Ventricular hypertrophy (二） Right Ventricular enlargment,V1 lead R/S1, V5 lead R/S1.05mV. right axis deviation+90. ST-T change,Right Ventricular enlargment,Atrial and Ventricular hypertrophy (三） Biventricular enlargement,Approximately normal ECG. Left or Right Ventricular Hypertrophy ECG Bive
9、ntricular Hypertrophy ECG,Biventricular enlargement,V. Ischemia and ST-T Segment,Forms: (1) Ischemia: a.subendocardial ischemia b.subepicardial ischemia(2) Injury.,clinical significance differential diagnosis,Ischemia and ST-T Segment,Ischemia and ST-T Segment,Ischemia and ST-T Segment,Ischemia and
10、ST-T Segment,VI. Myocardial Infarction,(一）Forms and mechanism 1 ) ischemia 2 ) infury 3 ）infarction,VI. Myocardial Infarction,VI. Myocardial Infarction,VI. Myocardial Infarction,VI. Myocardial Infarction,（二）Evolution of the infarction and duration the ECG 1 ) initial phase 2 ) acute phase 3 ) subacute phase 4 ) recovery phase,Myocardial Infarction,VI. Myocardial Infarction,The ECG and location of infarction,Myocardial Infarction,Myocardial Infarction,Nonspesific patterns of infarction,non-Q wave myocardial infarction infarction complicated with other diseases differential diagnosis,
