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[2] [3] Since the human body is a three-dimensional structure, the basic idea is to construct three orthogonal leads containing all the electric information. The three leads are represented by right-left axis (X), head-to-feet axis (Y) and front-back (anteroposterior) axis (Z).
R+S in a precordial lead < 4.5 mV [4] R in V5 or V6 < 2.6 mV; Increased amplitude indicates cardiac hypertrophy: Ventricular activation time (VAT) < 50 ms in V5 or V6 [4] < 30 ms in V1 [4] Measured in increased QRS amplitude [4] Q wave: Duration up to 40 ms in leads other than III and aVR [6] Amplitude less than 1/3 QRS amplitude [6] (R+S)
The precordial leads lie in the transverse (horizontal) plane, perpendicular to the other six leads. The six precordial electrodes act as the positive poles for the six corresponding precordial leads: (V 1, V 2, V 3, V 4, V 5, and V 6). Wilson's central terminal is used as the negative pole. Recently, unipolar precordial leads have been used to ...
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Inverted T wave is considered abnormal if inversion is deeper than 1.0 mm. Inverted T waves found in leads other than the V1 to V4 leads is associated with increased cardiac deaths. Inverted T waves associated with cardiac signs and symptoms ( chest pain and cardiac murmur ) are highly suggestive of myocardial ischaemia . [ 4 ]
Clicks – Heart clicks are short, high-pitched sounds that can be appreciated with modern non-invasive imaging techniques. [citation needed] Rubs – The pericardial friction rub can be heard in pericarditis, an inflammation of the pericardium, the sac surrounding the heart. This is a characteristic scratching, creaking, high-pitched sound ...
12-lead electrocardiogram showing ST-segment elevation (orange) in I, aVL and V1–V5 with reciprocal changes (blue) in the inferior leads, indicative of an anterior wall myocardial infarction. When there is a blockage of the coronary artery , there will be lack of oxygen supply to all three layers of cardiac muscle (transmural ischemia).
In medicine, the cardiac examination, also precordial exam, is performed as part of a physical examination, or when a patient presents with chest pain suggestive of a cardiovascular pathology. It would typically be modified depending on the indication and integrated with other examinations especially the respiratory examination .