03_06_09 ECG II

ECG II
Session Overview
Description
This session follows on from ECG I and presents the ECG as an electrical map of the heart. It details the abnormalities expected with myocardial infarction and left ventricular hypertrophy.

Learning Objectives
By the end of this session you will be able to:

• Recognise the ECG as an anatomical map of the heart and relate each lead to the correct anatomical area of the heart
• Recognise common normal variants in 12-lead ECG recording
• Distinguish a normal ECG from one indicating acute myocardial infarction, myocardial ischaemia, or left ventricular hypertrophy
• State the importance of T wave changes on the ECG

Prerequisites
Before commencing this session you should complete:

• ECG I (001-0141)

This is the second of three sessions about the ECG. This session explains how the ECG provides an assessment of the state of the myocardium, and how to recognise pattern changes on the ECG that can point to underlying pathology.

The characteristic waveform in each lead of a normal ECG can be identified digitally and an ECG be declared 'normal' by appropriate computer software.

The shape, morphology, of the QRS complex varies depending on the lead viewed. However, whilst the characteristic ST segment elevation of myocardial infarction (MI) is easily recognisable, subtle T wave morphological changes are a bit more tricky.

Correct interpretation of the 12-lead ECG and recognition of acute MI, myocardial ischaemia or left ventricular hypertrophy (LVH) are essential skills for all anaesthetists.