The EKG strip above is indicative of STEMI: ST-segment elevated myocardial infarction. Another common sign of acute MI is wide QRS complex. Research both pathological EKG signs and confirm their presence (or not) on this EKG strip. Furthermore, every EKG has universal voltage and time scale for interpretation of heart rate/period/amount of polarization etc. Again, learn how to apply this scale and answer following questions. a) What is the heart rate of this patient? b) Is the heart in a normal sinus rhythm? c) What part of heart is affected? d) Design a new method to diagnose the condition depicted above. I would like to see original bioengineering approach.
The Correct Answer and Explanation is :
To address your query thoroughly:
Pathological EKG Signs:
- ST-Segment Elevation (STEMI):
- STEMI is characterized by significant elevation in the ST segment, which typically suggests an acute myocardial infarction (MI), where the heart muscle is deprived of oxygen due to blocked blood flow. On an EKG, this appears as a significant upward deflection of the ST segment above the baseline in two or more contiguous leads.
- Wide QRS Complex: A wide QRS complex, typically greater than 0.12 seconds, often indicates a problem with the electrical conduction system of the heart, such as a bundle branch block or ventricular arrhythmia, which can be associated with a serious acute MI.
Heart Rate Calculation:
- Heart Rate: To calculate heart rate, we use the formula:
[
\text{Heart Rate} = \frac{60}{\text{RR Interval in seconds}}
]
Each small box on the EKG represents 0.04 seconds, so count the number of small boxes between two R waves and calculate the interval. For example, if the RR interval is 5 boxes (0.20 seconds), the heart rate would be 300 beats per minute (bpm) / number of boxes between R waves.
Questions Answered:
- Heart Rate of the Patient: The heart rate can be calculated by counting the number of large boxes between R waves, with one large box representing 0.2 seconds. If the RR interval is measured, the rate can be calculated as ( \text{Heart Rate} = 60 \div (\text{RR Interval in seconds}) ).
- Normal Sinus Rhythm: To determine if the rhythm is sinus, the following criteria should be met:
- The P wave must be present and consistent.
- The P waves should precede each QRS complex.
- The rhythm should be regular. If the rhythm appears irregular or there are abnormal P waves, then it is not sinus rhythm.
- Affected Area of the Heart:
- STEMI typically affects the myocardium, and depending on the leads with elevation, it suggests involvement of the anterior, inferior, or lateral wall. For instance, leads I, aVL, V5, and V6 can indicate lateral wall involvement, while II, III, and aVF may suggest inferior wall ischemia.
- New Method for Diagnosis:
- A bioengineering approach could involve developing a wearable device with EKG sensors that continuously monitors heart activity, integrated with AI-based algorithms to detect abnormalities like ST-segment elevation and wide QRS complexes. This system could alert healthcare providers in real time, prompting immediate action for suspected MI cases. It could also integrate with other biosensors, such as those monitoring blood oxygen levels, heart sound analysis, and biomarkers for further diagnostic confirmation.
In summary, accurate EKG interpretation, based on standardized voltage and time scales, provides vital information about heart function. STEMI and wide QRS complexes are critical pathological indicators of acute MI. A novel bioengineering diagnostic method could leverage continuous monitoring, advanced algorithms, and integration with other vital parameters to detect and respond to acute cardiovascular events.