Skip to main content

Diabetes - Symptoms, Causes, Precaution, Methods and more

  DIABETIES :- Diabetes Mellitus is a chronic metabolic disease. which is characterised by hyperglycemia resulting from insulin deficiency or insulin resistance. Diabetic Mellitus SYMPTOMS :- 3P :-  Polyuria (frequent urine)   Polyphagia ( very hungry)  polydipsia ( very thirsty) feeling tired blurry vision weight loss  delay wound healing HYPERGLYCEMIA High blood sugar/ high sugar level in blood. HYPOGLYCEMIA   Low blood sugar with a glucose value of usually less than 70mg/dl CAUSES To high dose of medication ( Insulin/ antidiabetic medication ) Delayed Meals Exercise Alcohol SYMPTOMS Shakiness Anxiety Sweating Irritability or Confusion Fast heart beat Dizziness Hunger and nausea Headaches Weakness Seizure/Unconsciousness TREATMENT Consume simple carbohydrates like half cup sweetened juice, 3 tablespoons of sugar, honey, chocolates or hard candy. Recheck your blood glucose after 15 minutes. If hyperglycemia continues, repeat the glucose supplements. Once...

ELECTROCARDIOGRAPHY BASIC

 What is electrocardiography (ECG)

Electrocardiography is a medical test in which diagnose cardiac disorder i.e. MI (myocardial infarction) etc. by measuring the electrical activity of the heart via electrodes placed on the limbs and chest wall and are transcribed on to graph paper to produce an electrocardiogram and also known as ECG/EKG.
 
                                  OR 
 
Electrocardiogram
 
Electro means electrical activity
 
Cardio means heart
 
Gram means graphical representation
 
An electrocardiogram is a graphically representation of an electrical activity of the heart and used in the investigation of heart disease.
 
The device is used is known as electrocardiograph.
 
NOTE -- The term electrocardiogram was introduced by Willem Einthoven in 1893
 
Later in 1924 Einthoven received the Nobel prize for his life's work.
 
 
 

Indication of ECG (Why it's done)

  • Due to cause of chest pain, palpitation, Dizziness, shortness of breath and weakness
  • To determine heart rate (bradycardia and tachycardia)
  • To diagnose abnormal heart rhythm (arrhythmias)
  • Differentiate between cardiology disease and respiratory disease
  • During cardiopulmonary resuscitation (CPR)
  • Evaluation of suspected electrolyte imbalance
  • Evaluation of rheumatic heart disease and congenital heart disease
  • To detect myocardial infarction, ischemia and the presence of prior infarction as well
  • How well certain heart disease treatments, such as a defibrillators and pacemaker are working.
  • To detect the effects and side effects of cardiology drugs
  
 

Contraindication of ECG

  • No absolute contraindications of ECG except patient refusal 
  

ECG PAPER (Recording)

 
The electrocardiogram is recorded on to standard paper traveling at a rate of 25mm/s
 
The paper is divided into large squares
 
Each large square have 25 small squares
 
Width of 1 large square is 5mm and equivalent to 0.2sec or 200ms
 
Width of 1 small square is 1mm and equivalent to 0.04sec or 40ms
 
NOTE --  The electrical activity of the heart detected by the electrocardiogram machine is measured in Millivolts.
 

Electrocardiogram Paper


 
 

12 Leads ECG system

 
There are six chest leads (V1 to V6) and six limb leads (I, II, III, aVR, aVL, aVF)
 
Six chest leads V1, V2, V3, V4, V5, V6 that view the heart in the horizontal plane.
 
Six limb leads I, II, III, aVR, aVL, aVF that view the heart in the vertical plane
 
The information from these 12 Leads (6 chest and 6 limb) is combined to form a standard electrocardiogram.
 
 

Electrode placement of ECG

 
V1 -- Right sternal edge, 4th intercostal space (between 4th and 5th ribs)
 
V2 --  Left sternal edge, 4th intercostal space (between 4th and 5th ribs)
 
V3 --  Between V2 and V4
 
V4 --  Mid-clavicular line, 5th intercostal space (between 5th and 6th ribs)
 
V5 --  Left anterior axillary line, horizontally in line with V4
 
V6 --  Mid- axillary line, horizontally in line with V4 and V5
 
RA --  On the Right arm, avoiding thick muscles
 
LA --  On the Left arm, avoiding thick muscles
 
RL --   On the Right leg, except bony prominence
 
LL --   On the Left leg, except bony prominence



  

Diagram of Normal ECG waveform
 

Normal ECG Waveform
  


Standard ECG Components

 
The ECG tracing is divided into the P wave, PR interval, QRS complex, QT interval, R-R interval, ST segment, PR segment, T wave and U wave.
 
P wave -- Depolarisation of atria
 
PR interval -- Time interval between onset of atrial Depolarisation and onset of ventricular Depolarisation
 
QRS Complex -- Depolarisation of ventricular consisting of the Q, R, and S wave
 
QT interval -- Time interval between onset of ventricular Depolarisation and onset of ventricular Repolarisation
 
R-R interval -- Time interval between two QRS Complexs
 
T wave -- Ventricular Repolarisation
 
ST Segment -- Show ST Segment Depression and ST Segment Elevation
 
ST Segment Depression -- Implies that the ST Segment is displayed such that it is below the level of the PR segment


 ST Segment Elevation -- Implies that the ST Segment is displayed such that it is above the level of PR segment
 
PR segment -- The flat line between the end of the P wave and the onset of QRS Complex
 
U wave -- Representation of Purkinje fibres
 
 

Standard ECG Components
 

Einthoven's Triangle

 
Einthoven's Triangle is an imaginary formation of three limb leads (I, II, III) in a Triangle used in electrocardiography, formed by the two shoulders and the pubis.
 
 
 
                             OR
 
Einthoven's Triangle is an imaginary formation of three limb leads (I, II, III) i.e the right arm (RA), left arm (LA), and the left leg (LA), were considered to form an equilateral triangle in the frontal plane with the heart in the center this is called einthoven's triangle.
 
 
 
Standard Limb Leads -- (Lead I, II, III) results from einthoven's views of the heart. Each lead represents the difference in voltage recorded at two of the limbs. They are bipolar recordings in the frontal plane.
 
Lead I    =  LA-RA
 
Lead II  =  LL- RA
 
Lead III =  LL- LA
 
 
Standard Bipolar Limb Leads

The axis of these leads defines the sides of an equilateral triangle. Each lead views the electrical activity of the heart (Dipole)
 
 
 
Augmented Limb Leads -- (aVR, aVL, aVF) record one limb minus a derived ground. They are unipolar recordings.
 
aVR = RA - 0
 
aVL = LA - 0
 
aVF = LL - 0
 
The axes of the augmented Limb leads are perpendicular to the axes of the standard Limb leads (i.e perpendicular to the sides of the equilateral triangle) and are in the frontal plane.


Augmented Unipolar Limb Leads

                                OR

Augmented Unipolar Limb Leads

The augmented Limb Leads obtain a graph of electrical forces as recorded from one limb at a time using a null point with a relative zero potential, thus they are unipolar.
 
 
 
NOTE- The Right Leg (RL) -- Electrode remove artifacts from the ECG and is not a directly participating factor in the visible trace.
 
 
 
To graphically represent the electrical forces in einthoven's triangle, we can draw them in such a way that they bisect each other passing through a common central point.


Hexaxial Reference System

Einthoven's Triangle Law


This low state that the sum of the electrical currents recorded in lead I and Lead II equal to the sum of the electric current recorded in lead II.
 
Lead I  + Lead III  = Lead II
 
​

​


 

Labels:

Popular posts from this blog

HUMAN CIRCULATORY SYSTEM/BLOOD VASCULAR SYSTEM

HEART CIRCULATORY SYSTEM OR  BLOOD VASCULAR SYSTEM The study of blood vascular system or circulatory system is called angiology    The vascular system is made up of the vessels that carry blood and lymph fluid through the body. It's also called the circulatory system. The arteries and veins carry blood all over the body. They send oxygen and nutrients to the body tissues.   BLOOD VESSELS 1  Arteries  2  Veins 3  Capillaries Differentiate between arteries and vein  CAPILLARIES They have only one layer i.e. simple squamous endothelium layer.  ANATOMY OF HEART Heart  is a coned shaped hollow structure equal to the size of puzzle fit. It is a mesodermally derived organ, is situated in the thoracic cavity, in between the two lungs (mediastinum), slightly tilled to the left. The heart weight between 200 to 425g.  The lower portion is apex and upper portion is base. Wall of heart  1.  Pericardium 2.  Myocardium 3....
Read more

ECG Interpretation/ How to read an ECG or EKG/ Characteristics of the normal ECG

  ECG INTERPRETATION BASIC  An ECG complex represents the electrical events occurring in one cardiac cycle. A complex consists of five waveforms labelled with the letters P, Q, R, S, and T. The middle three letters —Q, R, and S—are referred to as a unit, the QRS complex. ECG tracings represent the conduction of electrical impulses from the atria to the ventricles.    P WAVE  Small, Positive and smooth wave. Always +ve in lead II during sinus rhythm. P wave is virtually always +ve in leads aVL, aVF, I, V4, V5, and V6 and -ve in aVR lead. Frequently biphasic in V1 ( occasionally in V2)  the -ve deflection is normally <1mm. P wave duration should be < 0.12 sec. P wave amplitude should be <2.5 mm. Pathological P wave  Tall Tented  :-  Right Atrial Enlargement Bifid (looks like an M) :- Left Atrial Enlargement  PR INTERVAL Normal PR Interval :-  3-5 small squares                  ...
Read more

What is Cancer/Types, Symptoms, Causes, Treatment and Diagnosis of Cancer/ What is Silent Cancer

 CANCER  Cancer is also known as Tumor, and study of cancer is called oncology . Definition  Cancer means uncontrol and abnormal division of cells. They are very rapidly proliferate without any differentiation and apoptosis process. (Abnormal proliferative cell is called Neoplastic cell ) Or The uncontrolled growth of cell by its multiplication is known as Cancer. Types of cancer  There are two types of Tumor :- 1. Benign Tumor  2. Malignant Tumor Benign Tumor  Benign Tumor is also called mass of cell. It cannot spread from one location to other location. That means it is not show metastasis. This is a localised tumor. That means it is present only one location not spread to other location. Benign Tumor (Cancer) This type of tumor can remove from the body because it is located only on surface of organ. Example of Benign Tumor :-  Lipoma Myloma  Malignant Tumor  Malignant Tumor is very dangerous tumor because it can spread or can transfer from...
Read more

Atrial Fibrillation/Atrial Flutter

  Atrial Fibrillation  Atrial Flutter Atrial Fibrillation   (Afib) Afib stands for atrial Fibrillation (AF) Atrial Fibrillation is a type of arrhythmia or abnormal heart beat and is a major cause of stroke.  Atrial Fibrillation is an irregularly irregular and often very rapid heart rhythm that begins in heart upper chambers (Atria). in which the upper chambers of the heart (atria) beat out of coordination with the lower chambers of the heart (ventricle). ATRIAL FIBRILLATION FINDINGS ON ECG Findings Irregularly irregular QRS Complex P wave absent / no visible P wave present Heart beat range (100bpm - 160bpm) Types of Atrial Fibrillation There are three main types of atrial fibrillation.... Paroxysmal atrial Fibrillation Persistent atrial fibrillation Long standing persistent atrial fibrillation Paroxysmal Atrial Fibrillation It's episodes occurs less than one week and usually stops on its own without treatment. Persistent Atrial Fibrillation It's episodes occurs more ...
Read more