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Coronary Artery Anatomy as related to EKG Interpretation

Patients undergoing Percutaneous Transluminal Coronary Angioplasty (PTCA) are at an increased risk of coronary artery occlusion related to clot formation (thrombosis) or plaque rupture, especially in the acute period after procedure. It is imperative that individuals providing care for this patient population are knowledgeable in reading EKG's and are able to correlate EKG changes with acute coronary artery occlusions and / or spasms.

When a patient presents with chest pain, pressure, tightness, shortness of breath or other related symptoms status post PTCA, a STAT EKG should be ordered. When caring for a patient post PTCA, is important to know which coronary artery was ballooned and/or stented and be able to identify the EKG leads which reflect those coronary arteries.

The best way to learn how the EKG reflects the coronary anatomy is to take a systematic approach. Think about where the EKG leads are placed on the patient's chest and visualize the heart within the chest. This article assumes that the reader already knows how to read an EKG strip and understands what the P, Q, R, S and T represent on the EKG.

The limb leads are I, II and III. Lead I is between the right arm and left arm; Lead II is between the right arm and left leg; Lead III is between the left arm and left leg.

The precordial leads are V1- V6. V1 is the fourth intercostal space to the right of the septum; V2 is the fourth intercostal space to the left of the sternum; V3 is directly between leads V2 and V4; V4 is the fifth intercostal space at midclavicular line; V5 is at the same level as V4 but at the left anterior axillary line; V6 is level with V5 but is at the midaxillary line.

About the author: I have been a Registered Nurse since 1991. I have a Bachelor's and Master's degree in Nursing. My specialty is invasive cardiology.

Source: http://www.articlesbase.com/medicine-articles/coronary-artery-anatomy-as-related-to-ekg-interpretation-2641383.html

Frequently Asked Questions

  1. QUESTION:
    Do i have shingles or phn shingles ? what do i do?
    I am showing signs of having phn singles pain. Here are my system's : I am almost 100% I have have two shingles outbreak one 6 yrs ago and one about 4 years ago I never went to the doctors because it went away with in two weeks.both time I thought it was a rash. I went to the hospital last week for pains in my cheast, I thought I had a heart attack and was told their was possible tissue damage in my shoulder. followed up with my doctors and he said the Pimples on my chest and the pains were shingles. Then I start To put the pieces together. 8 yrs old have chicken pocs,10 tonsils remove, 11 some infection in my nostrol.Early 20s pancreas infected, in the hospital for week I've felt pains every morning for over 2 years and I would say it felt like twos on the "pain meter". I was told the pimples on my leg where hay fever,those are now scars on my leg.What if for over 6-10 years I have had shingles and never been treated. That the dry skin/hay fever , I put lotion on it and NEVER Scratched it. The pains I just downed played, I mean who's back,feet,arm dosent hurt once in a while. But I always had a overwhealming soreness in one part and never really said anything. The pain is now a 6, icant move my left arm and the pain travels from my cheast,back,feet. I went to the hospital with a 10+.I've taken some xrays and blood work is coming back soon. What should I do with work, they will have doctors notes saying I can't work, I've been their for 5 years. When I was doing the research it was a little scary to see the pictures of stuff I had on me 4-6 years ago. The pains and sensations that I have really fit.8 am a postive person If stress is a factor the past years has taken a toll on me besides the pains described I've gone their a divorce my mother passing and girlfriend cancer has been alot . I am only 29 years old.

    • ANSWER:
      You may be having the after shingles pain. Currently, there is no cure for PHN, and it cannot be prevented in all patients. Because the virus is no longer present after the blisters dry up, the antiviral drugs used to treat shingles are not useful in patients with PHN. For some people, PHN may improve over time without treatment, although not common. However, there are several treatment options approved by the FDA for PHN and PHN pain.

      You can take some of these medications by mouth in the form of a pill. There are also two topical options, a lidocaine patch and a capsaicin patch, that are applied directly to the skin where you feel the PHN pain. It is important to realize that every PHN patient responds differently to these different treatment options.

      Check here for more information.

      http://www.aftershingles.com/after-shingles-pain/treatment.aspx

  2. QUESTION:
    Odd Red Bumps on leg?
    Last night I found about 11 red bumps on the lower parts of my left leg? Their not big, alittle red like a zit but don't seem to have pus in them. I looked again today and I have about twice as much going higher(though the newer ones are more faint then the others).

    I researched it and thought it could be shingles or folliculitus but doesn't seem to match.
    Shingles- Mine don't hurt and don't seem to be like a rash but it does kinda look like it.
    Follicultius-Its around the hair on my legs, looks quite a bit like the picture and did kinda itch at first but doesn't match the discription all that well.

    Anything else this could be?

    (NOTE: I do not use anything different for shampoos, soaps etc and did not shave my legs. Nor could it be anything sexual because I've never had sex or anything past just kissing and it wasn't recent.)

    • ANSWER:
      Everyone told you..."Don't Let the Bed Bugs Bite!!"

  3. QUESTION:
    Got a rash that is killing me and I cant figure out what it is?
    Initially my legs were quite itchy, to the point of waking up to scratching. Small pimples appear mostly on my leg area, friction definitely triggers it and maybe sweating. I noticed after playing racquetball or ice hockey it was the worst. I haven't been playing either sport in a while. I assumed it was my hockey equipment, but I haven't played in months.

    Lately, 5 to 10 small white pimple appears on legs. If I don't put cream on them quickly, a red mark the size of a quarter will develop and it will itch and hurt, almost like a tact is stuck in my leg. I finally noticed my right leg is more sensative due to my work badge continually bumping that part of my leg, the inseams of my pants can cause irritation to. I have been using Bacitracin lately, but at first I was just using a skin moisturizer, which helps reduce the outbreaks.

    I tend to line dry most of my pants and started to suspect a "outbreak" from my washing machine. I have bleached it since, but I think it is more likely that line dried clothes are not as soft on the skin and it is more a friction issue. We use a skin sensative detergent.

    I been searching the internet for rashes and pictures of rashed, really disgusting stuff out there. I am freaked out that it could be scabies, but haven't seen any pictures that match and nobody else in the family has this issue and it has been going on for almost a year. I doesn't look like shingles , but it can be quite painful, it was really itchy all over my legs months ago, but now it manifests itself in a few white pimples with a red mark around them, they eventually turn red though as they heal.

    I also started thinking about bed bugs, mostly get it on my legs, but sometimes on my back of my neck and no pimples but slight symptoms of a rash on my face.

    I have been to the doctor, they suggested a low dose of an antihistamine and OTC moisturizer, helps but does not stop the symptoms. I also have not been great a keeping moisturized

    • ANSWER:
      Hi,

      You can identify the itching skin whether it is scabies rash or not. Find out more about scabies rash at

      http://scabies-rash.blogspot.com

      Thanks
      Aina



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