Introduction to Basic EKG

Introduction

An electrocardiogram (EKG or ECG) is a test that records the electrical activity of the heart over time. It helps diagnose heart conditions such as arrhythmias, heart attacks, and other cardiovascular issues.

How Does an EKG Work?

The heart generates electrical impulses that cause it to contract and pump blood. Electrodes placed on the skin detect these impulses and display them as waves on an EKG paper or monitor.

Understanding the EKG Waves

An EKG consists of several important waves and segments:

  • P wave : Represents atrial contraction.
  • QRS complex : Represents ventricular contraction (depolarization).
  • T wave : Represents ventricular recovery (repolarization).

How to Read a Basic EKG?

  1. Determine the heart rate : Count the number of large squares between two consecutive R-waves and use the formula (300/number of squares).
  2. Analyze the rhythm : Check whether the rhythm is regular or irregular by assessing R-R intervals.
  3. Examine the P waves : Verify if each P wave is followed by a QRS complex.
  4. Measure intervals :
    • PR interval (normal: 120-200 ms)
    • QRS duration (normal: ≤120 ms)
    • QT interval (varies with heart rate)

Common EKG Abnormalities

  • Bradycardia : Slow heart rate (<60 bpm)
  • Tachycardia : Fast heart rate (>100 bpm)
  • Atrial fibrillation : Irregular rhythm with no distinct P waves
  • Myocardial infarction (heart attack) : ST-segment changes, pathological Q waves

Conclusion

EKG is a fundamental tool in cardiology that helps identify heart problems early. Understanding its basics can improve awareness of cardiac health.

Source recommendations

1. American Heart Association Guidelines for Electrocardiography

  1. https://www.heart.org/en/health-topics/heart-attack/diagnosing-a-heart-attack/electrocardiogram-ecg-or-ekg
  2. https://www.ahajournals.org/doi/10.1161/circulationaha.108.191095
  3. https://pubmed.ncbi.nlm.nih.gov/19281932/
  4. https://www.ahajournals.org/doi/10.1161/circulationaha.108.191098
  5. https://pubmed.ncbi.nlm.nih.gov/10483977/

2. European Society of Cardiology Guidelines for EKG Interpretation

  1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Neonatal-Electrocardiogram-Guidelines-for-the-interpretation-of-the
  2. https://pubmed.ncbi.nlm.nih.gov/12269267/
  3. https://www.jacc.org/doi/10.1016/j.jacc.2017.01.015
  4. https://academic.oup.com/eurheartj/article-abstract/39/16/1466/2965923
  5. https://www.ahajournals.org/doi/10.1161/circulationaha.108.191098

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