THE VALUE OF ELECTROCARDIOGRAPHY


When evaluating a cardiac case, an electrocardiograph (ECG) should not be viewed as a means to diagnosis and treatment in its own right, but as one piece of the ‘jig-saw puzzle’ of clinical examination and investigative techniques.

ECGs are the definitive means for the diagnosis of dysrhythmias, but in association with other investigations may also suggest likely chamber enlargement, the presence of pericardial fluid, electrolyte disturbances, myocardial ischaemia and drug effects/toxicities.





Uses of electrocardiography


(1) Dysrhythmias
definitive diagnosis of an irregular heart rhythm in cardiac and non-cardiac cases
monitoring
(2) Electrolyte disturbances
hyperkalaemia (Addison's disease, acute renal failure, diabetic ketoacidosis)
hypokalaemia
hypercalcaemia
(3) Cardiac chamber enlargement
(4) Pericardial effusion
(5) Drug effects, e.g. digitalis toxicity, quinidine, propranolol
(6) Myocardial ischaemia and fibrosis
(7) Assessment of response to treatment (serial ECGs).

   THE ELECTROCARDIOGRAPH (ECG)
  FORMATION OF THE P-QRS-T COMPLEX
  RECORDING AN ELECTROCARDIOGRAM
  INTERPRETING THE ECG
  THE NORMAL ECG
  THE ABNORMAL ECG

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