P/qrs/t normal range

Electrocardiography (ECG) is one of the most vital and readily used screening tool in clinical medicine. It is inexpensive and easily obtained in both the inpatient and outpatient setting. The ECG is used to diagnose numerous cardiac conditions, including prior infarction and active cardiac ischemia, as well as conduction abnormalities such as atrial fibrillation and life-threatening tachycardias. The information provided by ECGs is also used in determining which type of implantable cardiac defibrillator should be used for the management of advanced heart failure. Numerous noncardiac conditions, including electrolyte abnormalities and medication side effects, are also detectable on ECG owing to their distinct effect on conduction patterns. [ A well-planned approach to 12-lead ECG interpretation will prevent the interpreter from missing crucial information. Key aspects in the interpretation of the 12-lead ECG include the heart rate, the heart rhythm (both atrial and ventricular), the electrical axis (both the P-wave axis and the QRS axis), and knowledge of the normal intervals. Next, determine the relationship of P waves to QRS complexes. Finally, analyze the QRS morphology and ST and T-wave segments. ECG paper commonly moves at 25 mm/second; thus, each small box (1 mm) is equivalent to 0.04 seconds (40 milliseconds), and each large box (5 mm) is equivalent to 0.2 seconds (200 milliseconds). At the beginning of an ECG, make note of the standardization square, normally 10 mm...

Courtesy of QRS Width Normal QRS width is 70-100 ms (a duration of 110 ms is sometimes observed in healthy subjects). The QRS width is useful in determining the origin of each QRS complex (e.g. sinus, atrial, junctional or ventricular). • Narrow complexes (QRS 100 ms) may be either ventricular in origin, or due to aberrant conduction of supraventricular complexes (e.g. due to bundle branch block, hyperkalaemia or sodium-channel blockade). Example ECG showing both narrow and broad complexes Sinus rhythm with frequent ventricular ectopic beats (VEBs) in a pattern of ventricular bigeminy. The narrow beats are sinus in origin, the broad complexes are ventricular. Narrow QRS Complex Morphology Narrow (supraventricular) complexes arise from three main places: • Sino-atrial node (= normal P wave) • Atria (= abnormal P wave / flutter wave / fibrillatory wave) • AV node / junction (= either no P wave or an abnormal P wave with a PR interval < 120 ms) Examples of Narrow Complex Rhythms: Broad QRS Complex Morphology Broad/Wide QRS Complexes • A QRS duration > 100 ms is abnormal • A QRS duration > 120 ms is required for the diagnosis of bundle branch block or ventricular rhythm Broad complexes may be ventricular in origin or due to aberrant conduction secondary to: • Bundle branch block ( • • Poisoning with sodium-channel blocking agents (e.g. • • • • Intermittent aberrancy (e.g. rate-related aberrancy) Example of a Broad Complex Rhythm: Ventricular tachycardia: Broad QRS complexes w...

Determining the heart axis is one of the most difficult steps on an By concept, the heart axis, or let’s call it by its proper name, the QRS axis, is nothing else but the direction of the total vector of the ventriclular depolarization. This may seem like it’s written in an alien language. To make it more more understandable, we can say the heart axis is the main direction of the electrical stimulus through the ventricles (I hope that’s simpler). If you do not want to rack your brains, in this website we can provide you with a Before calculating the heart axis, we must understand that To calculate the cardiac axis we will only use the limbs leads. Taking the Each of the leads “observes” the electrical stimuli in a different way. When the stimuli moves away it yields a negative deflection, positive if it approaches the lead. If it is perpendicular to the lead, it is biphasic. After this theoretical introduction, we can proceed to the heart axis calculation. Simple Method to Determine Heart Axis It will allow us to know in which quadrant is the electrical axis by looking at two leads. How? Very simple. We check whether the QRS deflection in leads I and aVF are positive or negative. With this we will be able to determine if the heart axis is normal or a deviation is present. • 1. If the QRS in leads I and aVF are positives: normal axis. • 2. If the QRS are negative in both leads: • 3. If the QRS is negative in lead I and positive in lead aVF: • 4. If the QRS is positive in le...

Systematic approach to ECG interpretation: efficient and safe method The 1.Rhythm Checklist Assess ventricular (RR intervals) and atrial (PP intervals) rate and rhythm: • Is • Is atrial rhythm regular? What is the atrial rate (beats/min)? • P-waves should precede every QRS complex and the P-wave should be positive in lead II. Commonfindings • • Causes of sick sinus syndrome (SSS). • Causes of tachycardia (tachyarrhythmia) with narrow QRS complexes (QRS duration 0,22 s: • PR interval 5 mm and at least one chest (precordial) lead with R-wave amplitude >10 mm; otherwise there is low voltage. • High voltage exists if the amplitudes are too high, i.e if the following condition is satisfied: S-wave V1 or V2 + R-wave V5>35 mm. • Look forpathological Q-waves. • Is the R-wave progression in the chest leads (V1–V6) normal? • Is the electrical axis normal? Electrical axis is assessed in limb leads and should be between –30° to 90°. Commonfindings • Wide QRS complex (QRS duration ≥0.12 s): Left bundle branch block. • Short QRS duration: no clinical relevance. • High voltage: Hypertrophy (any lead). Left bundle branch block (leads V5, V6, I, aVL). Right bundle branch block (V1–V3). Normal variant in younger, well-trained and slender individuals. • Low voltage: Normal variant. Misplaced leads. Cardiomyopathy. Chronic obstructive pulmonary disease. • Pathological Q-waves: Myocardial infarction. Left-sided pneumothorax. Dextrocadia. Perimyocarditis. Cardiomyopathy. Amyloidosis. Bundle bra...

Electrocardiography (ECG) is one of the most vital and readily used screening tool in clinical medicine. It is inexpensive and easily obtained in both the inpatient and outpatient setting. The ECG is used to diagnose numerous cardiac conditions, including prior infarction and active cardiac ischemia, as well as conduction abnormalities such as atrial fibrillation and life-threatening tachycardias. The information provided by ECGs is also used in determining which type of implantable cardiac defibrillator should be used for the management of advanced heart failure. Numerous noncardiac conditions, including electrolyte abnormalities and medication side effects, are also detectable on ECG owing to their distinct effect on conduction patterns. [ A well-planned approach to 12-lead ECG interpretation will prevent the interpreter from missing crucial information. Key aspects in the interpretation of the 12-lead ECG include the heart rate, the heart rhythm (both atrial and ventricular), the electrical axis (both the P-wave axis and the QRS axis), and knowledge of the normal intervals. Next, determine the relationship of P waves to QRS complexes. Finally, analyze the QRS morphology and ST and T-wave segments. ECG paper commonly moves at 25 mm/second; thus, each small box (1 mm) is equivalent to 0.04 seconds (40 milliseconds), and each large box (5 mm) is equivalent to 0.2 seconds (200 milliseconds). At the beginning of an ECG, make note of the standardization square, normally 10 mm...

Courtesy of QRS Width Normal QRS width is 70-100 ms (a duration of 110 ms is sometimes observed in healthy subjects). The QRS width is useful in determining the origin of each QRS complex (e.g. sinus, atrial, junctional or ventricular). • Narrow complexes (QRS 100 ms) may be either ventricular in origin, or due to aberrant conduction of supraventricular complexes (e.g. due to bundle branch block, hyperkalaemia or sodium-channel blockade). Example ECG showing both narrow and broad complexes Sinus rhythm with frequent ventricular ectopic beats (VEBs) in a pattern of ventricular bigeminy. The narrow beats are sinus in origin, the broad complexes are ventricular. Narrow QRS Complex Morphology Narrow (supraventricular) complexes arise from three main places: • Sino-atrial node (= normal P wave) • Atria (= abnormal P wave / flutter wave / fibrillatory wave) • AV node / junction (= either no P wave or an abnormal P wave with a PR interval < 120 ms) Examples of Narrow Complex Rhythms: Broad QRS Complex Morphology Broad/Wide QRS Complexes • A QRS duration > 100 ms is abnormal • A QRS duration > 120 ms is required for the diagnosis of bundle branch block or ventricular rhythm Broad complexes may be ventricular in origin or due to aberrant conduction secondary to: • Bundle branch block ( • • Poisoning with sodium-channel blocking agents (e.g. • • • • Intermittent aberrancy (e.g. rate-related aberrancy) Example of a Broad Complex Rhythm: Ventricular tachycardia: Broad QRS complexes w...

Determining the heart axis is one of the most difficult steps on an By concept, the heart axis, or let’s call it by its proper name, the QRS axis, is nothing else but the direction of the total vector of the ventriclular depolarization. This may seem like it’s written in an alien language. To make it more more understandable, we can say the heart axis is the main direction of the electrical stimulus through the ventricles (I hope that’s simpler). If you do not want to rack your brains, in this website we can provide you with a Before calculating the heart axis, we must understand that To calculate the cardiac axis we will only use the limbs leads. Taking the Each of the leads “observes” the electrical stimuli in a different way. When the stimuli moves away it yields a negative deflection, positive if it approaches the lead. If it is perpendicular to the lead, it is biphasic. After this theoretical introduction, we can proceed to the heart axis calculation. Simple Method to Determine Heart Axis It will allow us to know in which quadrant is the electrical axis by looking at two leads. How? Very simple. We check whether the QRS deflection in leads I and aVF are positive or negative. With this we will be able to determine if the heart axis is normal or a deviation is present. • 1. If the QRS in leads I and aVF are positives: normal axis. • 2. If the QRS are negative in both leads: • 3. If the QRS is negative in lead I and positive in lead aVF: • 4. If the QRS is positive in le...

Courtesy of QRS Width Normal QRS width is 70-100 ms (a duration of 110 ms is sometimes observed in healthy subjects). The QRS width is useful in determining the origin of each QRS complex (e.g. sinus, atrial, junctional or ventricular). • Narrow complexes (QRS 100 ms) may be either ventricular in origin, or due to aberrant conduction of supraventricular complexes (e.g. due to bundle branch block, hyperkalaemia or sodium-channel blockade). Example ECG showing both narrow and broad complexes Sinus rhythm with frequent ventricular ectopic beats (VEBs) in a pattern of ventricular bigeminy. The narrow beats are sinus in origin, the broad complexes are ventricular. Narrow QRS Complex Morphology Narrow (supraventricular) complexes arise from three main places: • Sino-atrial node (= normal P wave) • Atria (= abnormal P wave / flutter wave / fibrillatory wave) • AV node / junction (= either no P wave or an abnormal P wave with a PR interval < 120 ms) Examples of Narrow Complex Rhythms: Broad QRS Complex Morphology Broad/Wide QRS Complexes • A QRS duration > 100 ms is abnormal • A QRS duration > 120 ms is required for the diagnosis of bundle branch block or ventricular rhythm Broad complexes may be ventricular in origin or due to aberrant conduction secondary to: • Bundle branch block ( • • Poisoning with sodium-channel blocking agents (e.g. • • • • Intermittent aberrancy (e.g. rate-related aberrancy) Example of a Broad Complex Rhythm: Ventricular tachycardia: Broad QRS complexes w...

Electrocardiography (ECG) is one of the most vital and readily used screening tool in clinical medicine. It is inexpensive and easily obtained in both the inpatient and outpatient setting. The ECG is used to diagnose numerous cardiac conditions, including prior infarction and active cardiac ischemia, as well as conduction abnormalities such as atrial fibrillation and life-threatening tachycardias. The information provided by ECGs is also used in determining which type of implantable cardiac defibrillator should be used for the management of advanced heart failure. Numerous noncardiac conditions, including electrolyte abnormalities and medication side effects, are also detectable on ECG owing to their distinct effect on conduction patterns. [ A well-planned approach to 12-lead ECG interpretation will prevent the interpreter from missing crucial information. Key aspects in the interpretation of the 12-lead ECG include the heart rate, the heart rhythm (both atrial and ventricular), the electrical axis (both the P-wave axis and the QRS axis), and knowledge of the normal intervals. Next, determine the relationship of P waves to QRS complexes. Finally, analyze the QRS morphology and ST and T-wave segments. ECG paper commonly moves at 25 mm/second; thus, each small box (1 mm) is equivalent to 0.04 seconds (40 milliseconds), and each large box (5 mm) is equivalent to 0.2 seconds (200 milliseconds). At the beginning of an ECG, make note of the standardization square, normally 10 mm...

Determining the heart axis is one of the most difficult steps on an By concept, the heart axis, or let’s call it by its proper name, the QRS axis, is nothing else but the direction of the total vector of the ventriclular depolarization. This may seem like it’s written in an alien language. To make it more more understandable, we can say the heart axis is the main direction of the electrical stimulus through the ventricles (I hope that’s simpler). If you do not want to rack your brains, in this website we can provide you with a Before calculating the heart axis, we must understand that To calculate the cardiac axis we will only use the limbs leads. Taking the Each of the leads “observes” the electrical stimuli in a different way. When the stimuli moves away it yields a negative deflection, positive if it approaches the lead. If it is perpendicular to the lead, it is biphasic. After this theoretical introduction, we can proceed to the heart axis calculation. Simple Method to Determine Heart Axis It will allow us to know in which quadrant is the electrical axis by looking at two leads. How? Very simple. We check whether the QRS deflection in leads I and aVF are positive or negative. With this we will be able to determine if the heart axis is normal or a deviation is present. • 1. If the QRS in leads I and aVF are positives: normal axis. • 2. If the QRS are negative in both leads: • 3. If the QRS is negative in lead I and positive in lead aVF: • 4. If the QRS is positive in le...