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Related Concept Videos

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias

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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Electrocardiogram01:29

Electrocardiogram

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An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
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ECG Interpretation of Arrhythmias I: Sinus Arrhythmias01:16

ECG Interpretation of Arrhythmias I: Sinus Arrhythmias

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Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
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ECG Interpretation of Rhythms01:24

ECG Interpretation of Rhythms

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An electrocardiogram (ECG)graphically represents the heart's electrical activity on ECG paper or a monitor.
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage....
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Correlation between ECG and Cardiac Cycle01:25

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The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
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Electrocardiogram Fundamentals01:28

Electrocardiogram Fundamentals

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Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
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Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
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Crochetage Sign: An Invaluable Independent ECG Sign in Detecting ASD.

Anuj Sarma1

  • 1Department of Anaesthesia and Critical Care Medicine, Down Town Hospital, Guwahati, India.

Indian Journal of Critical Care Medicine : Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine
|March 12, 2021
PubMed
Summary

The crochetage sign on an electrocardiogram (ECG) can help diagnose atrial septal defects (ASD) in critically ill patients, especially when echocardiography is not feasible. This simple ECG finding is crucial for identifying congenital heart disease at the bedside.

Keywords:
ASDCongenital heart diseaseCrochetage signECGICURespiratory distress

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Intensive Care Medicine

Background:

  • Congenital heart disease diagnosis can be challenging in intensive care units, particularly with respiratory distress.
  • Electrocardiography (ECG) offers valuable insights for diagnosing and managing cardiac conditions.

Observation:

  • A 25-year-old female presented with acute respiratory distress post-delivery.
  • Echocardiography was not feasible due to poor echo window and patient positioning limitations.
  • ECG revealed right axis deviation, right bundle branch block (RBBB), and the crochetage sign in inferior leads.

Findings:

  • The crochetage sign, characterized by notching in the R wave apex of inferior leads (2,3,aVF), indicated the presence of an atrial septal defect (ASD).
  • The diagnosis of ASD was subsequently confirmed via echocardiography after patient stabilization.

Implications:

  • The crochetage sign is a valuable, independent ECG finding for diagnosing ASD, especially in resource-limited settings or when echocardiography is unavailable.
  • This highlights the importance of bedside ECG interpretation in critical care for timely diagnosis of congenital heart disease.