The electrocardiogram is the test done to study the correct behavior of the heart. It is painless and very simple, offers valuable information through electrodes located in the patient’s chest, the same, are attached to the equipment, and you get 12 leads, which measure the rhythm, the regularity of the beats, the size, the position of the atria and the ventricles.
That is why, for studies of the heart, the medical professional, must be very careful, possess adequate knowledge, avoid haste or neglect, to determine if the electrocardiogram, is right or wrong.
General Considerations for Performing the Electrocardiogram
In order to perform a correct study, it is necessary to determine if the leads are registered, since they are essential for the correct analysis, since it is common that a lead does not register the electrical mechanism, due to a poor connection of an electrode, and when this happens, it is necessary to place the electrode well and repeat the electrocardiogram.
The electrocardiograms offer images in the form of waves representative of the pulse of the heart, and usually appear a certain path considered standard, by cardiologists. Therefore, when this route presents different forms, it is considered that there is an abnormal electrocardiogram. However, it may be the result of arrhythmias in patients, caused by bradycardia, decreases in heart rate, tachycardia, or increased heart rate.
However, cardiac arrhythmias are not always malignant and sometimes do not symbolize a serious problem for the health of the patient. Therefore, it is important to respect the orders of cardiology specialists, as you are the only doctor who can determine exactly when an abnormal electrocardiogram should be of concern and when not.
Steps to avoid errors in electrocardiogram studies
First, the specialist should determine the heart rate using an electrocardiogram to determine whether the patient is in the presence of tachycardia, bradycardia or a normal heart rate. Which, must meet the following parameters for the scope and understanding of the reading:
- It should be taken into account that the printing of the expressed derivations correspond to the speed of 25 mm/s and the amplitude of 1 mV per 10 mm, and that the study does not have too many artifacts that make reading difficult.
- Be careful, in the poor contact of some electrode with the skin, since the presence of few isolated artifacts, do not hinder a correct reading of an electrocardiogram, but several of them can induce diagnostic errors.
- Applying the Einthoven method, which expresses the net amplitude of the QRS complex (cardiac rhythms) in the D2 derivation is equal to the sum of the net amplitudes of the QRS complexes of D1 and D3 (D2 = D1 + D3). If this is not true, the peripheral electrodes have been misplaced.
- The PR interval should be measured (normal between 0.12 s and 0.20 s) from the onset of the P wave to the onset of QRS.
- The QT interval should be measured from the onset of the QRS complex to the end of the T-wave. The QT interval varies depending on the heart rate, so the QT interval should be corrected for heart rate
- Taking into account the cardiac electrical axis is one of the steps of the analysis of the electrocardiogram that usually costs more work. A safe and fast method to know if it is normal is to determine if the QRS complex of the I and aVF leads is positive.
To finish the analysis, you should evaluate each of the waves and intervals of the electrocardiogram that we have not previously evaluated.
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