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Introduction to ECG

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Module 5: Common ECG Abnormalities

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1. Atrial Fibrillation (AF)

  • ECG Findings:

    • Irregularly irregular rhythm

    • No distinct P waves (fibrillatory waves instead)

    • Variable R–R intervals

  • Clinical Significance: Risk of stroke, need anticoagulation

2. Atrial Flutter

  • ECG Findings:

    • “Saw-tooth” flutter waves (usually at 300 bpm)

    • Regular ventricular response if conduction ratio is fixed (2:1, 3:1)

3. Ventricular Tachycardia (VT)

  • ECG Findings:

    • Wide QRS (>0.12 sec)

    • Rate >100 bpm

    • Can be monomorphic or polymorphic

  • Danger: Can lead to cardiac arrest

4. Ventricular Fibrillation (VF)

  • ECG Findings:

    • Chaotic baseline, no identifiable QRS complexes

    • No effective cardiac output

  • Emergency: Immediate CPR + defibrillation

5. Heart Blocks

  • First-degree AV Block: PR interval >0.20 sec (constant)

  • Second-degree AV Block:

    • Mobitz I (Wenckebach): PR interval gradually lengthens until a QRS is dropped

    • Mobitz II: Sudden dropped QRS without PR lengthening (dangerous)

  • Third-degree AV Block (Complete Heart Block):

    • No relationship between P waves and QRS

    • Escape rhythm may be narrow or wide

မြန်မာဘာသာ Version (Page 2)

၁။ Atrial Fibrillation (AF)

  • ECG တွင်တွေ့ရသောအချက်များ:

    • မမှန်မကန် ရစ်မ်

    • P wave မပြန့်ဘဲ fibrillatory wave တွေ့

    • R–R interval မညီညာ

  • အရေးကြီးချက်: သွေးတက်ကြောချို့တဲ့မှု (stroke) အန္တရာယ် မြင့်

၂။ Atrial Flutter

  • ECG တွင်တွေ့ရသောအချက်များ:

    • Saw-tooth ပုံစံ flutter wave

    • ၂:၁ သို့မဟုတ် ၃:၁ conduction ratio တွင် R–R regular

၃။ Ventricular Tachycardia (VT)

  • ECG တွင်တွေ့ရသောအချက်များ:

    • QRS ကြီး (>0.12 sec)

    • နှုန်း > 100 bpm

    • Monomorphic သို့မဟုတ် Polymorphic ဖြစ်နိုင်

  • အန္တရာယ်: Cardiac arrest ဖြစ်နိုင်

၄။ Ventricular Fibrillation (VF)

  • ECG တွင်တွေ့ရသောအချက်များ:

    • Chaotic baseline

    • QRS မရှိ

  • အရေးပေါ်: CPR + Defibrillation လုပ်ရန်လိုအပ်

၅။ Heart Block များ

  • First-degree AV Block: PR interval > 0.20 sec

  • Second-degree AV Block:

    • Mobitz I: PR interval တဖြည်းဖြည်းကြာပြီး QRS ကျသွား

    • Mobitz II: QRS ကျသွား (PR မကြာ)

  • Third-degree AV Block:

    • P wave နှင့် QRS မသက်ဆိုင်

    • Escape rhythm ဖြစ်နိုင်

၆။ ST Elevation နှင့် Depression (MI Indicators)

  • ST Elevation: Myocardial infarction acute phase

  • ST Depression: Ischemia (or reciprocal change)

Q: What is the hallmark of AF on ECG?
A: Irregularly irregular rhythm with no P waves.

Q: What does “saw-tooth” pattern indicate?
A: Atrial flutter.

Q: What is the main danger of ventricular fibrillation?
A: Cardiac arrest (no cardiac output).

Q: How to differentiate Mobitz I from Mobitz II?
A: Mobitz I = gradual PR prolongation before dropped QRS; Mobitz II = sudden drop.

Q: What does ST elevation indicate?
A: Acute myocardial infarction.

Q: What does ST depression suggest?
A: Myocardial ischemia or reciprocal change.

Q: What is first-degree AV block?
A: PR interval > 0.20 sec, all P waves conducted.

Q: What is monomorphic VT?
A: VT with uniform QRS shape.

Q: How to treat VF?
A: CPR and immediate defibrillation.

Q: What is complete heart block?
A: No relationship between atrial and ventricular activity.
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