Basic ECG

What is it for?
It is a valuable tool in recording the heart’s
function.

It records electrical impulses that stimulate

the heart to contract.
Indications for ordering an ECG:
To determine the cardiac rate.
To accurately define cardiac rhythm.
To diagnose old or new MI.
To identify intracardiac conduction
disturbances.
To aid in the diagnosis of ischemic heart
disease, preicarditis, myocarditis,
electrolyte abnormalities, and pacemaker
malfunction.
Heart cells are charged or polarized in the
resting state, but when electrically stimulated,
the “depolarized” and contract.
DEPOLARIZATION

+ +
- - - - - - - - -

MYOCARDIUM

- - - - - - - - -
+ +

STIMULUS
 Once the myocardium has been depolarized,
it can be measured through electrodes
STIMULUS
attached to the skin.

+ +
- - - - - - - - - -

MYOCARDIUM

- - - - - - - - - -
+ +

DEPOLARIZATION
STIMULUS

+ +
- - - - - - - - - -

MYOCARDIUM

- - - - - - - - - -
+ +

DEPOLARIZATION
Einthoven’s Triangle

REFERENCE POINT

HEART III
II

Foot
 (-) (-)
(-)
AVR AVL
(+) (+)

I
(-) (+)

(-) III II (-)

AVF (+)
(+) (+)
ECG is recorded on a ruled paper.
The smallest divisions are 1 mm square
There are 5 small squares between the heavy
black lines.

1.0 s
5 mm = 0.20 s

1 mm = 0.04 s
The standard EKG is composed of 6 chest leads
and 6 limb leads
Position of Chest Leads:
V1 – 3rd or 4th ICS (R)
sternal border.
V2 – 3rd or 4th ICS (L)
sternal border.
V3 – Posterior
Clavicular/Halfway
between V2 & V4.
V4 – 5th or 6th ICS (L) mid
clavicular line.
V5 – 5th or 6th ICS (L)
ant. axillary line.
V6 – Mid Axilla (L)
How to read an ECG strip?

1. Make sure that the ECG strip has proper

identification labels (name, age, room,
doctor, time that was taken).
2. There should be “standardization”.
3. Determine if the leads are placed
correctly.
4. Is the rhythm sinus?
5. What is the rate?

Normal rate: 60 – 100/min.

Rate = Number of small squares (R-R)
1500
300 150 100 75 60 50
• Sinus Tachycardia
• Rate is more than 100/min.
• Sinus Bradycardia
• Rate is less than 60/min.