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Chapter-04 Electrocardiogram—Clinically Relevant to Congenital Heart Diseases

BOOK TITLE: Clinical Diagnosis of Congenital Heart Disease

Author
1. Kulkarni ML
2. Satpathy M
ISBN
9788184481617
DOI
10.5005/jp/books/10126_4
Edition
1/e
Publishing Year
2008
Pages
6
Author Affiliations
1. JJM Medical College, Davangere 577004, Karnataka, JJM Medical College, Davangere, Karnataka
2. Haripur Road, Dolamundai, Cuttack, Odisha, India
Chapter keywords

Abstract

In spite of increasing use of more sophisticated methods for cardiac evaluation, electrocardiogram (ECG) still remains an essential, convenient, cheap and easily available tool in clinical cardiology. ECG is a part and parcel of clinical examination for cardiac patient. Technically correct ECG with correct interpretation when correlated with clinical findings help the physician to reach the diagnosis closely. It is essential that, pediatric ECGs should be interpreted in the light of information regarding age, history, physical examination, drug therapy and heart size as seen in the chest radiograph. For proper interpretation a systemic evaluation is necessary. First step in an ECG is to determine the heart rate and then look at the rhythm and its electrical axis. Next systematically look at the PR interval, QT interval, QRS complex, P waves, Q waves and T waves. Several typical patterns give important clue to the diagnosis. Specific effort should be made to record suitable and correct ECG in case of neonate or infant. The electrode used is also small one (½ inch diameter). V3R and or V4R should always be recorded in addition to other chest leads. Precordial V3 is usually not taken in neonates or infants because of small precordium.

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