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Don Drapper @hanafi_mohamad
, 12 tweets, 2 min read Read on Twitter
How to ECG
So actually mcm mana ko nak baca ecg. Ada beberapa benda kena tgk untuk membolehkan ko buat diagnosis
1) rate
2) sinus or not
3) regularity
4) st elevation or depression
5) T abnormality
6) presence of Q wave
7) QT interval
8) PR interval
9) R wave progression
Oh terlupa satu lagi, kena comment
10) qrs complex: wide or narrow
So nk kire rate ko boleh tgk kt ecg machine ataupun manually kira pakai formula: 300/R-R interval
Nak tahu ecg tu sinus atau tak.
P wave mesti ada sebelum qrs complex. Kat lead V2, p mesti upright. Lagi satu kat lead I, II mesti upright jugak. Baru boleh dikatakan sinus ecg
Regularity, ko tgk R-R interval dia, sekata atau x. Kalau x, maka irregular lah dia. Kena tgk pulak irregularly irregular atau regularly regular
Lepas tu qrs complex wide atau narrow. Normal qrs complex (narrow) is within 0.06-0.1 second. Senang cite kalau lebih dari 3 kotak kecik maka wide lah dia
Next st elevation. Dia ada 6 cause yg utama:
1) benign early repolarization
2) acute MI
3) pericarditis
4) LV aneurysm
5) Printzmental's Angina( vasospasm)
6) Bundle branch block
St depression pun ada 6 cause
1)reciprocal change/ posterior MI
2) subendocardial MI
3) Ischemia
4) LVH with repolarization abnormality
5) Digoxin
6) Hypokalemia
T wave abnormalities ada 3:
1) tall/tented
2) inversion
3) biphasic
Setiap satu ni boleh memberikan diagnosis (penyebab).
Q wave ni normaly less than 0.04 seconds. Senang cite less than one small box. Kalau lebih ko dah boleh conclude dia ada sama ada dua benda.
1) dia ada old infarct
2) hypertrophic cardiomayopathy
Qt interval. Normally T wave dia xlebih dr separuh R-R interval. Kalau lebih atau prolonged ko dah kena cuak. Sbb may indicate pt akan dpt torsade de pointes
Last skali ko usha, r wave progression. R wave ni dia menunjukkan left ventricle punya function, jantung pump elok ke x. Nak tgk ok ke x, ko tgk lead V3. Ko kire r wave kalau lebih dari 3 small box itu dah kira good r wave progression la tu
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