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Whitbread, consultant nurse and paramedic, suggests ten rules of the normal ECG, deviation from which is likely to indicate pathology. [83] These have been added to, creating the 15 rules for 12-lead (and 15- or 18-lead) interpretation. [84] Rule 1: All waves in aVR are negative.
The use of additional ECG leads like right-sided leads V3R and V4R and posterior leads V7, V8, and V9 may improve sensitivity for right ventricular and posterior myocardial infarction. In spite of these limitations, the 12 lead ECG stands at the center of risk stratification for the patient with suspected acute myocardial infarction.
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The hexaxial reference system is a diagram that is used to determine the heart's electrical axis in the frontal plane. The hexaxial reference system, better known as the Cabrera system, is a convention to present the extremity leads of the 12 lead electrocardiogram, [1] that provides an illustrative logical sequence that helps interpretation of the ECG, especially to determine the heart's ...
Progressive degeneration of the electrical conduction system of the heart can lead to third-degree heart block. This may be preceded by first-degree AV block, second-degree AV block, bundle branch block, or bifascicular block. In addition, acute myocardial infarction may present with third-degree AV block. [3]
The typical meaning of an "ECG" is the 12-lead ECG that uses 10 wires or electrodes to record the signal across the chest. Interpretation of an ECG is the basis of a number of cardiac diseases including myocardial infarction (heart attack) and arrhythmias such as atrial fibrillation.
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).
Patients may exhibit signs of agonal breathing, which to a layperson can look like normal spontaneous breathing, but is a sign of hypoperfusion of the brainstem. [citation needed] It has an appearance on electrocardiography of irregular electrical activity with no discernable pattern. It may be described as "coarse" or "fine" depending on its ...