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ELECTROCARDIOGRAMA NORMALDOCENTEEDUARDO BARRENECHE BAUTE
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PADRE DE LA ELECTROCARDIOGRAFIA
• 1860-1927
• Nobel de ed!"!#$192%• C&eo el
'$l($#)e*&o de"+e&d$• De,!#!) l$
e*$#d$&!.$"!)#• Le d!o #ob&e $ l$
o#d$ P/RT• De&!($"!o#e
*$#d$&d DIDIIDII
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Electrocardiograma
• Registro gráfico de los potenciales eléctricos que
produce el corazón.
• Obtenidos desde la superficie corporal(*).
• Mediante un electrocardiógrafo
(*) esde!• El interior de las ca"idades cardiacas! E#E$%RO&R'M' ntraca"itario• El interior del esófago! Electrograma intraesofágico
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UTILIDAD DEL
EG
CRECIMIENTOCA3IDADEBLO/UEO
ARRITMIA
ENFERMEDADDCORONARIA
ARRITMIA
ELECTROLITO
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$ 4o " # e$ 4$&$ o$& e
CG e "o# el 4$"!e#*e e#
de"5b!*o +4!#o ! el 4$"!e#*e
4&ee#*$ o&*o4#e$ el &e'!*&o e
debe $"e& "o# l$ e#o&
ele($"!)# 4o!ble e# l$ "+$l el
4$"!e#*e e*7 ")odo
! e !4o!ble $"o*$&lo debe
4e&$#e"e& e#*$do debe
"olo"$& deb$:o de lo 4!e
4e&!)d!"o o l!b&o 4$&$ e(!*$& l$
!#*e&,e&e#"!$ de "o&&!e#*e
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TOMA DEL EG
TOMA DEL EGHay que explicarle al paciente en
que consiste el examenDescubrir sólo los brazos, piernas y pecho con el fin de
mantener una adecuada temperatura del mismo.
Apoyar la cabeza en una almohada.
Vigilar que la aplicación de las correas sea adecuada
!o debe quedar ni muy apretadas, ni muy sueltas".
#reguntarle al paciente si se siente bien con la
temperatura ambiental, de no sentirse, abrigarlo lo anterior para e$itar la presencia de temblor por
escalofr%o"
diferenciar de temblores patológicos, como el de la
enfermedad de #ar&inson".
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TOMA DEL EKG (unipolares y bipolares)
P$&$ "o#e"*$& lo ele"*&odo e debe d!!#+!& l$&e!*e#"!$ de l$ 4!el P$&$ e*o e l!4!$ l$ 4!el "o# $l"oolo e# + de,e"*o $4l!"$& 'el "o#d+"*o& 4$&$ e:o&$& l$ "$l!d$d
del *&$.o l$ "$#*!d$d debe e& 4e;+e<$ 4$&$ #o d!!#+!& e#e="eo l$ &e!*e#"!$ de l$ 4!el P$&$ $4l!"$& lo ele"*&odo4&e"o&d!$le e# +# *)&$= (ell+do e debe $4l!"$& 'el
"o#d+"*o&
Lo "$ble de lo ele"*&odo #o debe# e*$& *!&$#*e
4$&$ e($l+$& l$ 4&e!)# $de"+$d$ de l$ "o&&e$ e 4+ede
!#*&od+"!& +# dedo 4o& deb$:o de e*$ de *$l ,o&$ ;+e
l$ "o&&e$ #o ;+ede #! de$!$do *!&$#*e #! de$!$do
+el*$ U#$ "o&&e$ + $4&e*$d$ o"$!o#$&> $&*e,$"*o
4o& *eblo& +"+l$&
?D)#de e debe# $4l!"$& lo ele"*&odo e# lo b&$.o@H$ do 4o!b!l!d$de
L$ > +$d$ e e# l$ 4$&*e $#*e&!o& del $#*eb&$.o e*$ .o#$*!e#e e#o (ello ;+e el do&o del $#*eb&$.o
E# el b&$.o $;+ lo o(!!e#*o de lo dedo #o "$+$&>#!#*e&,e&e#"!$ 4o& l$ "o#*&$""!)# +"+l$&
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PRECORDIALEP$&$ l$ de&!($"!o#e 4&e"o&d!$le e +$#lo ele"*&odo de (e#*o$ b+lbo de 'o$ o"+4$ lo "+$le *$b!# o# 5*!le e# el
"$o de 4&ee#"!$ de +<)# e# +#$e=*&e!d$d $4+*$d$ o "+$#do l$ e=*&e!d$d
4&ee#*$ 5l"e&$ o ;+e$d+&$ ;+e!4o!b!l!*$# l$ 4o*+&$ del ele"*&odo ++$l
! el ele"*&odo #o e o*!e#e olo el 4$"!e#*e 4+ede$+d$& $ o*e#e&lo ! *e #o 4+ede "ol$bo&$& e
4+ede +$& +#$ *o$ll$ e"$ 4$&$ "o'e&lo 4+e*o ;+e! *e e "o'!do 4o& ;+!e# e*> *o$#do el ECG e
4&od+"e !#*e&,e&e#"!$ $l !#*&od+"!& "o&&!e#*e $l*e&#$
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TOMA DEL EGEl ECG e debe &e'!*&$& !e4&e e# o&de#"o# l$ !'+!e#*e e"+e#"!$ DI DII DIII $3R$3L $3F 31 32 3 3% 3 36
e &e"o!e#d$ &e'!*&$& "$d$ de&!($"!)# $le#o d+&$#*e
A + (e. e &e"o!e#d$ *o$& $l ,!#$l +# DIIl$&'o de 4o& lo e#o 6 $ 8 e' e*o4e&!*!&> 4&e"!$& "$&$"*e&*!"$ de$&&!*!$ d+&$"!)# o "$b!o del !#*e&($lo PRe#*&e o*&o
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EKG VIBRADO ( TEMBLORMUSCULAR)
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E3OLUCION
DELO
ELECTROCARDIOGRAFO
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Electrocardiógrafo
• Cables de conexión del aparato al paciente• cables a las etremidades! (R+'+,+-)• cables a la región precordial (-/0-)
• Amplificador de la señal
• Inscriptor de papel
Ro1o 'marillo
,egro -erde
Ángulo deLouis
V1! 2 E... 1unto al esternón
V2! 2 E... 1unto al esternón
V3! Entre -3 4 -
V4! 52 E... #. Medio $la"ic.
V! 52 E... #. 'ilar 'nterior
V!! 52 E... #. 'ilar Media
" # A# $# V%
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L CTROCARDIOGRAF
A
BICA
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L CTROCARDIOGRAFO
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E*!$do 4&o,eo&?/+ o4!#!)# le e&e"e# lo e;+!4o ;+e *&$e# l$!#*e&4&e*$"!o#e del EG e# el &e'!*&o@ +"$
(e"e lo 4$"!e#*e lle'$# + $l$&$do 4o& *$le!#,o&e &e+l*$ d!,"!l e=4l!"$&le lo be#!'#o de lo$ll$.'o o (!"e(e&$ E*o e "o4l!"$ $5# $"+$#do (!e#e# "o# el ello de $l'5# 4&o,e!o#$l
E# #+e*&o o4!*$l +# e;+!4o *$b!# *!e#ee$ 4o!b!l!d$dJ 4e&o $#*e de ;+e lo !4&!$
$4$'o el e;+!4o
De #!#'+#$ $#e&$ $"e4*$&$ el !#,o&e de +#$4$&$*o #! ;+e e d!'$ ;+ *e#'o ;+e $"e&
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PAPELDELELECTROCAR
DIOGRAMA
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PAPEL DEL EG
3ELOCIDAD 2 K
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3ELOCIDAD 2 K e'1 013 101 3
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TANDARIACION
3 LOCIDAD 2 O 0 MM G
D1-D2-DE-A3R-A3L-A3F
31-32-3E-3%-3-36E
D2 LARGO8
10 MM----------------------1M3OLT
MM-------------------------1M3OLT
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ITEMA
DEDERI3ACIONE
ELECTROCARDIOGRAFICA
P+#*o de "o#*$"*o e#*&e el ele"*&o"$&d!)'&$,o l$
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BIPOLAREUNIPOLARE
PRECORDIALEI/UIERDA DERECHA
LEIMEDRANO
EOFAGICA
P+#*o de "o#*$"*o e#*&e el ele"*&o"$&d!)'&$,o l$+4e&,!"!e del 4$"!e#*e 4o& do#de e "$4*$# lo4o*e#"!$le el"*&!"o 'e#e&$do 4o& el Co&$.)#
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D RI3ACION BIPOLAR DI-DII-
DIII
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D RI3ACION UNIPOLAR
A3R- A3L-A3F
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DIDIIDIIIAVRAVLAV!
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DI-DII-DIII-A3R-A3L-A3F
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#e4 de Eint6o"en! 3 7 / 8 9
#a amplitud de una determinada onda en la deri"ación 3+ es igual a la suma de las
amplitudes de las deri"aciones de / 4 9 de la misma onda
L&nea axilar anterior
L&nea mediocla'icular
L&nea axilar media
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V" V# V$ V% V& V' V V V*
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V"V#V$V%V&V'VVV*
LE+IS
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LE+ISVISUALI,ACI-. O.DA /
/RECORDIALES DEREC0AS(IAM
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/RECORDIALES DEREC0AS(IAMDEREC0ODE1TROCARDIAS)
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D RI3ACION D M DRANO
1-2-EIAM D R CHO
DERI3ACIONE UNI BIPOLARE
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DERI3ACIONE UNI BIPOLAREONA ANTOMICA /UE EQPLORA
PRECORDIALE ONA
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PRECORDIALE ONAANATOMICA /UE EQPLORA
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DERI3ACIONE
EOFAGICA
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EG
NORMAL
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ONDA- GM NTO-
INT R3ALO
Noe#"l$*+&$ del
Ele"*&o"$&d!o'&$$ No&$l
O#d$ P-/R-T-U
e'e#*o T-PR
I#*e&($lo PR-/R-/T
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R+*!#$ de !#*e&4&e*$"!)# del CG de
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+4e&,!"!e
e debe $"e& +# $#>l!! de 10 $4e"*o
LO 10 MANDAMI NTO1 R!*o2 F&e"+e#"!$ "$&d!$"$
O#d$ P% I#*e&($lo PR I#*e&($lo /R6 Co4le:o /R
7 e'e#*o T8 O#d$ T9 O#d$ U
10I#*e&($lo /T
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R+*!#$ de !#*e&4&e*$"!)# del CG de
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+4e&,!"!e
e debe $"e& +# $#>l!! de 10 $4e"*o
LO 10 MANDAMI NTO1 R!*o2 F&e"+e#"!$ "$&d!$"$ O#d$ P% I#*e&($lo PR I#*e&($lo /R6 Co4le:o /R
7 e'e#*o T8 O#d$ T9 O#d$ U10I#*e&($lo /T
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FR CU NCIA CARDIACA
M TODO PARA
NCONTRAR LA
FR CU NCIA CARDIACA
N RITMO R GULAR
CUANTO CUADRO O
CUADRITO HA NTR
RR
RITMO IRR GULAR
•R GLA D L E00
"+$d&o '&$#de
•R GLA D L 100
"+$d&o 4e;+e<o
• D /R N 1E
o E0 6 CUADRO
GRAND
FORMULA PARA LA FC EN
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FORMULA PARA LA FC ENRITMO REGULARE
00 SSSSSSSSSSSSSSSS RR CUADRO
100 SSSSSSSSSSSSSSSSSS
RR CUADRITO
FRECUENCIA CARDIACA
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EDAD
RN 1%0 0
1-6 ee 1E0 %
6-12 ee 11 %0
12-2% ee 110 %0
2-6 $<o 10 E
6-12 $<o 9 E0
12 $<o 82 2
FRECUENCIA CARDIACA
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FRECUENCIA CARDIACAREGLA DEL 00
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CUANDO EL RITMO E
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IRREGULAR
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R+*!#$ de !#*e&4&e*$"!)# del CG de
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+4e&,!"!e
e debe $"e& +# $#>l!! de 10 $4e"*o
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ACTIVACI-. .ORMAL DE LAS2
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AUR2CULAS
D#
ÂPd (Eje Aurícula derecha)• De arriba abajo•
De atrás adelante• De derecha a izquierda.
ÂPi (Eje Aurícula izquierda)• De derecha a izquierda• De adelante atrás
ÂP (Eje de la P)
• De arriba abajo• De derecha aizq.• De atrásadelante
D#
Aurícula izquierdaN. Sinusal
Aurícula derecha
3/
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ÂPi
D1
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a"# a"$
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- 1 sP
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P NORMAL DII-31
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P NORMAL DII-31
ONDA P
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l$ &e4&ee#*$"!)# '&>,!"$ de l$ de4ol$&!.$"!)# $+&!"+l$&
L$ 4e#d!e#*e $"e#de#*e &e4&ee#*$ l$ de4ol$&!.$"!)# de l$ $+&"+l$
de&e"$ l$ 4e#d!e#*e de"e#de#*e l$ de l$ $+&"+l$ !.;+!e&d$
L$ o#d$ P !de e#o de 100 e# e#*!do o&!.o#*$l + $4l!*+d e
e#o& $ 02 3 e# e#*!do (e&*!"$l
!4o&*$#*e #o ol(!d$& ;+e l$ &e4ol$&!.$"!)# $+&!"+l$& e*>
e#$"$&$d$ e# el "o4le:o /R
ANORMALIDADE DE LA ONDA P
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P PULMONAR
'()HA#)'#
P MITRAL
E/0/D0S%N203ND0AS43$02A DE$ "0
P IN3ERTIDARITMO DE LA UNION A3
DE54#32A#D0A
0N23##E24A 602A207N DE$3S E$E24#3D3S
E54 A#02$A#ES
AUENCIA DE PONDA F ,
Blo;+eo !#+$*&!$l
%$44E# A#02$A#
%A
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CRECIMIENTO O
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DILATACION AURICULARE
AURICULA DERECHA
AURICULA I/UIERDA
BIAURICULAR
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P PULMONAL
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P
D 0 A -20V
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D 0 A -20V
MITRAL
CAI
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CAI
CAI
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CAI
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NORMAL-CAI-CAD
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ONDA P
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CRECIMIENTO AURICULARBILATERAL
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BILATERAL
ONDA P
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NORMAL
•100 MILI GUNDO
•2 MM O 02 3OLT
CAI
/ A.C0A MITRAL 4"55MILISEGU.DOS
/ BIMODAL
/ 6 E. V"E7E A LA I,8UIERDA
CAD
/ /ICUDA /ULMO.ALE4#9&MM O 59#& M:ol;/ 666 E. V"E7E A LA DEREC0A
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R+*!#$ de !#*e&4&e*$"!)# del CG de
+4e&,!"!e
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e debe $"e& +# $#>l!! de 10 $4e"*o
LO 10 MANDAMI NTO1 R!*o2 F&e"+e#"!$ "$&d!$"$ O#d$ P
% I#*e&($lo PR% I#*e&($lo /R Co4le:o /R
6 e'e#*o T7 O#d$ T8 O#d$ U9 I#*e&($lo /T
PR
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PRREFLEAEL TIEMPO DE CONDUCCION
AURICULAR
EL RETARDO FIIOLOGICOEN LA UNION A3
LA CONDUCCION HIPURINE
?/UE EQPREA LA P EL PR EL /R@
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EL /R@
NORMAL
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NORMAL
• DEDE EL PRINCIPIO DE LAP HATA EL PRINCIPIO DEL/R
• 3ALORE NORMALE $$o& ,&e"+e#"!$ PRe#o&e
•011-020 EGUNDO
• 110 A 200 MILIEGUNDO
ANORMAL
• W200 MILIEGUNDOBLO/UEO A3
• X110 MILIEGUNDOINDROME DEPREEQCITACION
• P
PRWFC XPR
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WFC XPR
PR
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PR
CAUA DE ANORMALIDAD DELPR
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LARGOBLO/UEO A3
FIEBRE REUMATICA
ACCION DIGITALICA
CORTO
INDROME DE PREEQCITACION3ARIABLE
FENOMENO DE ENCEBACH
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R+*!#$ de !#*e&4&e*$"!)# del CG de
+4e&,!"!e
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e debe $"e& +# $#>l!! de 10 $4e"*o
LO 10 MANDAMI NTO
1 R!*o2 F&e"+e#"!$ "$&d!$"$ O#d$ P
% I#*e&($lo PR I#*e&($lo /R6 Co4le:o /R
7 e'e#*o T8 O#d$ T9 O#d$ U10I#*e&($lo /T
INTER3ALO /R
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3A DEDE ELPRINCIPIO DE LA /
HATA EL FINAL DE LA
R O DE LA
3ALORE NORMALE
006 A 010 EGUNDO60 A 100MILIEGUNDO
W010 100M!l!e'+#doBLO/UEO DE
RAMA BLO/UEOFACICULARECRECIMIENTO DE3ENTRICULO
R+*!#$ de !#*e&4&e*$"!)# del CG de
+4e&,!"!e
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e debe $"e& +# $#>l!! de 10 $4e"*o
LO 10 MANDAMI NTO
1 R!*o2 F&e"+e#"!$ "$&d!$"$ O#d$ P
% I#*e&($lo PR I#*e&($lo /R6 Co4le:o /R
7 e'e#*o T8 O#d$ T9 O#d$ U10I#*e&($lo /T
COMPLEO /R
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MORFOLOGIA
EE ELECTRICO
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DEFINICION DE LAONDA DEL /R
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ONDA DEL /R
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DE.OMI.ACI-. DE LAS O.DAS DELECG
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CAUA DEANORMALIDADE DEL /R
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ANORMALIDADE DEL /R
BAO 3OLTA
e#o& de OBEIDADIAMHIPOTIROIDIMO
DERRAME PERICARDICOEPOC
ALTO 3OLTA
HIPERTROFIA 3ENTRICULARE
PAREDE TORAQICA DELGADA
NIYO
ANCHO
BLO/EO
HIPERTROFIA
EQT 3ENTRICULARE
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3ECTOR I
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EPTAL
3ECTOR IIPARED LIBRE
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PARED LIBRE
3ECTOR III
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BAAL
( ( ( ( ( ( ( ( ( ( ( ( ((((( (( (
) ) ) ) ) ) ) ) ) ) ) ) ) ) ),
"eposo
: 8 (5)+ $a( (/;)+ Mg88 3+5+ Cl) (/;9)+ $a88 (5)
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( (( (( (( (( ( ( ( ( ( ( ( ( ( ( ( ( ( (
) A)# * (+1,-# ,a( +1,-# )
) Mg88+4,- )) ) ) ) ) ) ) ) ) ) ) ) ) ) )
)., mV
) ) ) ) ) ) ) ) ) ( ( ( ( ( () () (
) () () () ) ) ) ) ) ) ) ) ( ( ( ( ( (
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,
)., mV
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( )
( )( )( )( )
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) ) ) ) ) ) ) ) ) ) ( ( ( () * () /rote&nas () ) ) ) ) ) ) ) ) ) ( ( ( (
,
)., mV
(
( ( ( ( ( ( ( ( ( ( ( ( ((((( (( (
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,
)., mV
$élula polarizada
' =
/otencial de Acción ransmembrana
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$
E
Efectos del "ector de despolarización sobre
un electrodo eplorador
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un electrodo eplorador
espolarizaci>n
) (
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ONDA R PROGREI3IDAD
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CAUA DEANORMALIDADE DEL /R
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/
BAO
3OLTA
e#o& de
OBEIDADIAMHIPOTIROIDIMODERRAME PERICARDICOEPOC
ALTO
3OLTA
HIPERTROFIA 3ENTRICULARE
PAREDE TORAQICA DELGADA
NIYO
ANCHO
BLO/EO
HIPERTROFIA
EQT 3ENTRICULARE
HIPERTROFIA DEL 3ENTRICULOI/UIERDO
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• 0 O B R E C A R G A 0 I 0 T O L I C A
• A U M E N T O P A R E D
• C A 3 I D A D N O R M A L
• E A - H T A - C O A
CONCENTRICA
• 0 O B R E C A R G A D I A 0 T O L I C A
• A U M E N T O C A 3 I D A D
• P A R E D N O R M A L
• I A - I T - C O R T O C I R C U I T O 0
EQCENTRICA
• H I P E R T R O F I A 0 E P T A LMIOCARDIOPATIAHIPERTROFICA
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EE ELECTRICO
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• e e#*!e#de 4o& e:e el"*&!"odel "o&$.)# el ">l"+lo de l$
d!&e""!)# e#*!do del (e"*o&
el"*&!"o &e+l*$#*e de l$+$ de "$d$ +#o de lo5l*!4le (e"*o&e ;+e e
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E1e Eléctrico <lano Crontal
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aV" aVL
aV6
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$ ;2
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9er $uadrante 2 $uadrante
8;2
09;2
8/3;2
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EE
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• EE DEL /R ENTRE 0 Z 90
• EE DE LA ONDA P ENTRE 0 Z80
• EE DE LA ONDA T ENTRE 0 Z90
COMPLEO /R EE ELECTRICOE NACE CON EL EE A LA DERECHA
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E 3A ROTANDO HACIA LA I/
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PAO PARA ENCONTRAR EL EE
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• - ! el /R e !od!,>!"o e# DII el [/Re*> e# -0\ ) Z10\
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- ! el /R de $o& 4o!*!(!d$d e*> e# DII el [/R e o&!e#*$ $Z60\
- ! el /R de $o& 4o!*!(!d$d e*> e# DIII el [/R e o&!e#*$ $Z120\
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R+*!#$ de !#*e&4&e*$"!)# del CG de
+4e&,!"!e
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1 R!*o2 F&e"+e#"!$ "$&d!$"$ O#d$ P
% I#*e&($lo PR I#*e&($lo /R6 Co4le:o /R7 e'e#*o T
8 O#d$ T9 O#d$ U10I#*e&($lo /T
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T NORMAL PATOLOGICODEBE ER IOELECTRICO
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POR EQCEPCION UPRADENI3ELADOCONCA3IDAD HACIA ARRIBA 3AGOTONICO-
ATLETA
PUEDE ETAR POR ENCIMA DE LA LINEAIOELECTRICA LO LLAMAMO
UPRADENI3ELZ
PUEDE ETAR POR DEBAO DE LA LINEAIOELECTRICA LO LLAMAMO
INFRADENI3EL-
T UPRADENI3ELADOC$+$ de e'e#*o
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T +4&$ de#!(el$do
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LEION UBEPICARDICA
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T UPRADENI3ELADO LEION UBEPICARDICA
T INFRADENI3ELADO LEION UBENDOCARDICA
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EGMENTO TUPRADENI3ELADO INFARTODEL MIOCARDIO
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CAUA DE INFRADENI3EL DELEGMENTO T
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Le!)#
+be#do">&d!"$F>&$"o d!'o=!#$
d!+&*!"o H!4o]$le!$
LEION UBEND0CARDICA
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EGMENTO TINFRADENI3ELADO
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EGMENTO TINFRADENI3ELADO
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T DECENO PATOLOGICO NORMALEATLETA-REPOLARIACION PRECO
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LEION UBEPICARDICA
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T UPRADENI3ELADO LEION UBEPICARDICA
T INFRADENI3ELADO LEION UBENDOCARDICA
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EGMENTO TUPRADENI3ELADO INFARTODEL MIOCARDIO
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INFARTO DEL MIOCARDIO OBER3ARLA E3OLUCION DEL EGMENTO T
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INFARTO DEL MIOCARDIO OBER3ARLA E3OLUCION DEL EGMENTO T
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R+*!#$ de !#*e&4&e*$"!)# del CG de
+4e&,!"!e
e debe $"e& +# $#>l!! de 10 $4e"*o
LO 10 MANDAMI NTO
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1 R!*o2 F&e"+e#"!$ "$&d!$"$ O#d$ P
% I#*e&($lo PR I#*e&($lo /R6 Co4le:o /R7 e'e#*o T
8 O#d$ T9 O#d$ U10I#*e&($lo /T
ONDA TDEBE ER POITI3A
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LA R PR NTACI^N GRFICA
D LA R POLARIACI^N
3 NTRICULAR I MPR 3A
DIRIGIDA N L MIMO NTIDO
D L /R /U LA PR C D 2E
PART D LA R
AIMETRICA RAMA ACENDENTELENTA-RAMA DECENDENTE
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E28 de ni9o nor:al de ; a9os con 4 () en "1!
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D!,e&e#*e o&,olo'$ de o#d$ T
A No&$l 4o!*!($ B A"+!#$d$ C Ne'$*!($$!*&!"$ D Ne'$*!($ !*&!"$ E Ne'$*!($ 4&o,+#d$ "o# o#d$ R $l*$ T!#,&$ de#!(el$do F Ne'$*!($ !*&!"$ "o# /T l$&'o
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T NEGATI3A IMETRICAI/UEMIA UBEPICARDICA
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I/UEMIA UBEPICARDICA
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I/U MIA UB PICARDICA
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<
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I/UEMIA UBENDOCARDICA
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• =0PE#>A$E/0A
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• =0P3>A$E/0A
R+*!#$ de !#*e&4&e*$"!)# del CG de
+4e&,!"!e
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1 R!*o
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1 R!*o2 F&e"+e#"!$ "$&d!$"$ O#d$ P
% I#*e&($lo PR I#*e&($lo /R6 Co4le:o /R7 e'e#*o T
8 O#d$ T9 O#d$ U10I#*e&($lo /T
• Onda !
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-alores del E$& del ritmo sinusal normal
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• Onda !• =a1o "olta1e (F /D9 de la % de la
misma deri"ación)• $uando se registra sigue a la onda
% con su misma polaridad.
• @e suele registrar me1or en -9 4
- 4 con frecuencias cardiacas
ba1as.
• @u origen no es bien conocido (Repolarización de las fibras de <urHin1e+
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ONDA UREPREENTA LA
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REPREENTA LAREPOLARIACION
DE LA FIBRA DEPURINE
ONDA U• DEBE ER POITI3A
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• DEBE ER POITI3A• E 3IUALIA EN LA
HIPOALEMIA• EN E3ENTO
CEREBRO3ACULAREHEMORRAGIA
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ONDA UPROMIN NT
IN3ERTIDA
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HIPOALEMIA
HIPERCALCEMIA
OBREDOI
DIGITALICA DEADRENALINA
CARDIOPATIAI/UEMICA
HIPERCALCEMIA
IN3ERTIDA
HIPERALEMIA
CARDIOPATIAI/UEMICA
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R+*!#$ de !#*e&4&e*$"!)# del CG de
+4e&,!"!e
e debe $"e& +# $#>l!! de 10 $4e"*o
LO 10 MANDAMI NTO
1 R!*o
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1 R!*o2 F&e"+e#"!$ "$&d!$"$ O#d$ P
% I#*e&($lo PR I#*e&($lo /R6 Co4le:o /R7 e'e#*o T
8 O#d$ T9 O#d$ U10I#*e&($lo /T
INTER3ALO /T E el *!e4o ;+e *&$#"+&&e
e#*&e el !#!"!o del "o4le:o/R l ,! l d l d T
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e#*&e el !#!"!o del "o4le:o/R el ,!#$l de l$ o#d$ TDebe ed!&e do#de e=!*$
o#d$ / Re4&ee#*$ el,e#)e#o de
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3ALORE NORMALE DEL /T20----%%0 e'
MUERE $*$ %0
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MUERE $*$ %0e'
MENO DE 0_ DEL RRNO PUEDE ALIR UNA
DROGA /UE PRODUCAALARGAMIENTO DEL /T
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/T LARGOU#$ ,o&$ &$&$ de /TL
#d&oe de e&(ell L$#'e-
U#$ ,o&$ &$&$ de /TL
#d&oe de e&(ell L$#'eN! l LN * ) !
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#d&oe de e&(ell L$#'e-N!ele# LN e $+*o)!"$&e"e!($ e "$&$"*e&!.$ 4o&o&de&$ "o#'#!*$ b!l$*e&$l delo #e&(!o 4&olo#'$"!)# del
!#*e&($lo /T > $&"$do +# $l*o &!e'o de #"o4e&e"+&&e#*e +e&*e 5b!*$
#d&oe de e&(ell L$#'e-N!ele# LN e $+*o)!"$&e"e!($ e "$&$"*e&!.$ 4o&
o&de&$ "o#'#!*$ b!l$*e&$l delo #e&(!o 4&olo#'$"!)# del!#*e&($lo /T > $&"$do
+# $l*o &!e'o de #"o4e&e"+&&e#*e +e&*e 5b!*$
#d&oe de e&(ell L$#'e-N!ele# LN e $+*o)!"$&e"e!($ e "$&$"*e&!.$ 4o&
o&de&$ "o#'#!*$ b!l$*e&$l delo #e&(!o 4&olo#'$"!)# del!#*e&($lo /T > $&"$do
+# $l*o &!e'o de #"o4e&e"+&&e#*e +e&*e 5b!*$
L$ ,o&$ > "o5# del /TL#d&oe de Ro$#o-$&d
R "$&d$"o E*e"$#$lo4$*$ e $o"!$ $ &e*&$o
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R "$&d$"o E*e"$#$lo4$*$ e $o"!$ $ &e*&$oe# l$ &e4ol$&!.$"!)# (e#*&!"+l$&
e $#!,!e*$ "l#!"$e#*e4o& #"o4e +e&*e 5b!*$ 4o&$&&!*!$ (e#*&!"+l$&ee4e"!$le#*e *o&$de de4o!#*e
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/T• C$+$ de !#*e&($lo /T l$&'o• - #d&oe de /T l$&'o $d;+!&!do• - #d&oe de /T l$&'o "o#'#!*o
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#d&oe de /T l$&'o "o#'#!*o• - H!4o]$le!$• - H!4o"$l"e!$
• C$+$ de !#*e&($lo /T "o&*o• - #d&oe de /T "o&*o• - I#*o=!"$"!)# "o# d!'o=!#$
• - H!4e&"$l"e!$• - H!4e&]$le!$
INTER3ALO /TA MENORFRECUENCIA MA LARGO EL /T
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