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EKG / ECG

The heart's electrical conduction system:

The heart is, in the simplest terms, a pump made up of muscle tissue. Like all pumps, the heart requires a source of energy in order to function. The heart's pumping energy comes from a built-in, electrical, conduction system.

An electrical stimulus is generated by the sinus node (also called the sinoatrial node, or SA node), which is a small area of specialized tissue located in the right atrium (right upper chamber) of the heart. Under normal conditions, the sinus node generates an electrical stimulus every time the heart beats (60 to 190 times per minute, depending on the age of the child and his/her activity level). This electrical stimulus travels down through the conduction pathways (similar to the way electricity flows through power lines from the power plant to your house) and causes the heart's chambers to contract and pump out blood. The right and left atria (the two upper chambers of the heart) are stimulated first and contract a short period of time before the right and left ventricles (the two lower chambers of the heart).

The electrical impulse then travels from the sinus node to the atrioventricular (AV) node, where it stops for a very short period, and continues down the conduction pathways via the bundle of His into the ventricles. The bundle of His divides into right and left pathways to provide electrical stimulation to both ventricles.

Normally, the electrical impulse moves through the heart's conduction system, and the heart contracts. Each contraction represents one heartbeat. The atria contract a fraction of a second before the ventricles so their blood empties into the ventricles before the ventricles contract.

What is an electrocardiogram (ECG)?

An electrocardiogram (ECG or EKG) is one of the simplest and fastest procedures used to evaluate the heart. Electrodes (small, plastic patches) are placed at certain locations on your child's chest, arms, and legs. When the electrodes are connected to the ECG machine by lead wires, the electrical activity of your child's heart is measured, interpreted, and printed out for the physician's information and further interpretation.

Why is an ECG performed?

The electrical activity of the heart is measured by an electrocardiogram. By placing electrodes at specific locations on the body (chest, arms, and legs), a graphic representation, or tracing, of the electrical activity can be obtained. Changes in an ECG from the normal tracing can indicate one, or more, of several heart-related conditions.

Some medical conditions which may cause changes in the ECG pattern include, but are not limited to, the following:

This list is presented as an example. It is not intended to be a comprehensive list of all conditions which may cause changes in the ECG pattern.

An ECG may also be performed for other reasons, including, but not limited to, the following:

How does the physician know what an ECG means?

Almost everyone knows what a basic ECG tracing looks like. But what does it mean?

Illustration of a basic EKG tracing
Click Image to Enlarge

When your child's physician studies your child's ECG, he/she looks at the size and length of each part of the ECG. Variations in size and length of the different parts of the tracing may be significant. The tracing for each lead of a 12-lead ECG will look different, but will have the same basic components as described above. Each lead of the 12-lead is "looking" at a specific part of the heart, so variations in a lead may indicate a problem with the part of the heart associated with the lead.

What is the procedure for an ECG?

An ECG can be performed almost anywhere, as the equipment is very compact and portable. Thus, your child may undergo an ECG in a physician's office, the ECG department of the hospital or clinic, in a procedure or testing area, in the emergency department, or even in the hospital room or bed. The equipment used includes the ECG machine, skin electrodes, and lead wires which attach the electrodes to the ECG machine.

An ECG normally takes approximately five to 10 minutes, including attaching and detaching electrodes. During an ECG:

Depending on the results of the ECG, additional tests or procedures may be scheduled to gather further diagnostic information.

Click here to view the
Online Resources of Cardiovascular Disorders


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