The Accuracy and

Diagnostic
Processing Using
Electrocardiograms
EMILEE SMITH
*SOME INFORMATION IN THIS PRESENTATION COMES FROM OUTSIDE SOURCES.

Independent Study Mentorship

Fall 2016
o

Student: Emilee Smith

Mentor: Megan Stearns, RN

Mentorship site: Clear Lake Regional Medical Center, the heart

tower

ISM teacher: Mrs. Kristi Click

Topic: The diagnostic processing and accuracy of an

electrocardiogram

What is Independent Study

Mentorship?
o

Independent study mentorship is a semester long course where students

receive active learning directly from a mentor to gain insight and
knowledge of potential jobs. Throughout the mentorships, students are
requires to research a topic to create a mid- term presentation

Project Title
o

This semester, I have chosen to research the accuracy and

diagnosis process using electrocardiograms because the first step
to diagnosing any heart problem is with the reading of an
electrocardiogram. Many people underestimate the use of
electrocardiograms, and also the electrocardiograms accuracy is
also undermined. Equipment is depended upon for many diagnosis
in the medical field. The accuracy is rarely called into question as
most people defend it saying that its science, it has to be true.

This power point will cover abnormalities of the heart that can be
diagnosed by electrocardiograms.

Clear Lake Regional Medical

Center: Heart Tower
o

The only heart specialization hospital south of Texas Medical Center,

the heart tower at Clear Lake Regional oversees many
cardiovascular conditions . The hospitals receive emergency
patients and can, if needed, perform heart surgeries.

"Clear Lake Heart and Vascular Hospital." Clear Lake Heart , No.1 in Heart Care in
Houst on -. N.p., n.d. Web. 05 Oct. 2016. <http://clearlakeheart.com/>.

About my mentor
o

In 2008, Megan attended College of the Mainland earing an

associate degree in art in general studies. She entered into the
nursing program in 2012, graduating in 2014 with an associates
degree in nursing. Currently she is working towards her bachelors
degree.

Right out of school, she began working at St. Josephs, moving to

UTMB six months after. Taking some time off, Megan was employed
by St. Davids North Austin Medical Center. In July of 2016, she
moved to Clear Lake and is employed at Clear Lake Regional.

Megan mostly had worked in med- surg with a focus on

orthopedics, some bariatrics. She is now in the cardiovascular
department.

About my mentor (Cont.)

Weebly Online Portfolio

Throughout the semester, I have compiled all of my assignments into

a website. The website is

http://emileesmithism.weebly.com/

Key Points
o

Definition of electrocardiogram

Explanation of product

Pictures obtained from

mentorship of an
electrocardiograph

Concluding statement

Special thanks to

Describe the procedure of an

electrocardiograph

Bibliography

Explain the different types of

abnormalities represented on an
electrocardiogram

Provide pictures as to what

abnormalities look like on an
electrocardiogram

Definitions

Leads: Cable with connections within the electronics of the machine desgined for an
electrode placed at a particular point on the body.

Electrodes: A part of an electric conductor through which a current enters or leaves.

The uninsulated conductive part of a pacing lead.

Atrium: The upper chambers of the heart. The left side transmitting blood to the
ventricles from the pulmonary veins and the right side transmitting blood into the
ventricles from the Vena Cava.

Ventricle: The lower chambers of the heart. The right side pumps blood into the lungs
and the left side pumps oxygenated blood into the systemic arterial circulation.

Sinus Node (SA): Group of specialized cells located in the right atrium near the superior
vena cava. Considered the hearts natural pacemaker.

Atrioventricular Node (AV): Located on the posterior side of the right atrium near the
tricuspid valve. Recieves signals from the SA node. Controlling the heart rate, the AV
node allows time for the atria to empty and close before stimulating the ventricles.

What is an Electrocardiogram?
o

A tracing representation of the hearts electrical action derived by

the amplification of the minutely small electrical impulses normally
generated by the heart

There are many reasons someone might be requested to get an

electrocardiogram by a doctors, some symptoms and not limiting
to; chest pain, breathing problems, tiredness and weakness, uneven
heart sounds, and any pounding feelings.

"What Is an Electrocardiogram?" Nat ional Heart, Lung, and Blood Inst itute. USA.gov, 1
Oct. 2010. Web. 2 Oct. 2016. <https://www.nhlbi.nih.gov/health/healthtopics/topics/ekg>.
"Electrocardiogram | Definition of Electrocardiogram by Medical Dictionary."The
Free Dict ionary. Farlex, n.d. Web. 05 Oct. 2016. <http://medicaldictionary.thefreedictionary.com/electrocardiogram>.

How is an electrocardiogram
taken?
o

An electrocardiogram also is called an EKG or ECG. Sometimes the

test is called a 12-lead EKG or 12-lead ECG. This is because the
heart's electrical activity most often is recorded from 12 different
places on the body at the same time. (NHLBI contributors page 1)

To begin an electrocardiogram, a nurse will attach sensors in the

form of sticky pads, also known as electrodes. The electrode
patches have the same size similar to a quarter.

The duration of the test is estimated to be around 10 minutes.

"Electrocardiogram | Definition of Electrocardiogram by Medical Dictionary."The Free

Dict ionary. Farlex, n.d. Web. 05 Oct. 2016. <http://medicaldictionary.thefreedictionary.com/electrocardiogram>.

What is the procedure for taking an

EKG?
o

https://www.youtube.com/watch?v=jxGdbaC8H68

UIChildrens. "What Is an Electrocardiogram (EKG)?" YouTube. YouTube, 19 Apr. 2012. Web. 10 Oct. 2016.
<https://www.youtube.com/watch?v=jxGdbaC8H68>.

Which cardiac arrhythmias can an

electrocardiogram diagnose?
o

Hypertrophy
o

Left and Right Ventricular

Atrial

Bundle Branch Blocks

Ischemia

V-Fib

Tachycardia

A-Fib

AV block

Atrial Enlargement

PQRST Complex
P- Wave: The
contraction of the
atrium. Also where the
SA node transmits
impulses to the AV
node
PR Segment: After
atrial contraction.
Allowing time for
ventricles to fill with
blood
PR Interval: Time
from beginning of
atrial contraction to the
beginning of
ventricular contraction
QRS Complex:
Contraction of both
ventricles

T- Wave: The relaxation

of the ventricles
ST Segment: Time
between the end of
ventricular contraction
and the beginning of
ventricular recovery
QT Interval: Time from
beginning of contraction
of both ventricles (QRS
Complex) to the T wave.
Both of the ventricles are
contracting and relaxing.

What do cardiac arrhythmias look

like on an electrocardiogram?

Cardiac Arrhythmias on
electrocardiograms
Sinus Rhythm: Regular Rhythm of
heart beart
First Degree Block: Prolonged PR
indicating a delay at the AV node
Bundle Branches

Cardiac Arrhythmias on
electrocardiograms
Sinus Bradycardia: Heart
beats less than 60 bpm

Cardiac Arrhythmias on
electrocardiograms
Sinus Rhythm: P waves
are round and upright
with a QRS complex
following behind. Atrial
and ventricular rhythm
are regular.

How accurate is an
electrocardiogram?
o

Study conducted to research how often or easy it is for a healthcare

worker to misinterpret an electrocardiogram

The prevalence of atrial fibrillation was 8.4%. Interpretative software

was the most accurate method of reading electrocardiograms but
did not give a rhythm diagnosis in 109 (4.3%) and missed 26 (12%)
cases of atrial fibrillation

The statistics are showing that the computer system is the most
accurate when reading an electrocardiogram. However it is stating
that the computer system is not always 100% accurate with the
readings.

Twenty per cent of cases of atrial fibrillation were missed, and the
probability that a positive diagnosis was correct was only 41%.
Hobbs, Richard, Ellen T. Murray, and Roger Holder. "Accuracy of Diagnosing Atrial Fibrillation on Electrocardiogram by
Primary Care Practitioners and Interpretative Diagnostic Software: Analysis of Data from Screening for Atrial Fibrillation
in the Elderly (SAFE) Trial." British Medical Journal. British Medical Journal, 23 Aug. 2007. W eb. 2 Oct. 2016.
<http://www.bmj.com/content/335/7616/380?linkType=FULL&resid=335/7616/380&journalCode=bmj>

Questions

At this time, I would like to answer any questions from the audience.

Conclusion
o

Electrocardiograms are beneficial in determining if any

abnormalities are present in the heart. However, they can be
challenging to read and give a proper diagnosis. Thus, requiring a
second opinion or another test.

This topic is interesting as it facilitated my understanding to

cardiology and allowed me to question the accuracy of modernday medical machines.

Special Thanks To
o

I would like to give special thanks to everyone who encouraged me

throughout the semester specifically my mentor Megan Stearns, RN
and my teacher Kristi Click, RN. With the combination of
encouragement and instructions, theyve cultivated and inspired
me to achieve my aspirations. I would also like to give a huge
thanks to my parents, whom have kept me on track, challenged,
and motivated me throughout my educational years.

Bibliography
o

Al Ghatrif, Majd, MD, and Joseph Lindsay, MD. "A Brief Review: History to Understand Fundamentals of
Electrocardiography." Journal of Communit y Hospit al Int ernal Medicine Perspect ives. Journal of Community
Hospital Internal Medicine Perspectives, 30 Apr. 2012. Web. 04 Oct. 2016.
<http://www.jchimp.net/index.php/jchimp/article/view/14383>.

"Clear Lake Heart and Vascular Hospital." Clear Lake Heart , No.1 in Heart Care in Houst on -. N.p., n.d. Web.
05 Oct. 2016. <http://clearlakeheart.com/>.

"Electrocardiogram | Definition of Electrocardiogram by Medical Dictionary."The Free Dict ionary. Farlex, n.d.
Web. 05 Oct. 2016. <http://medical-dictionary.thefreedictionary.com/electrocardiogram>.

Feldman, Henry, and Mariano Rey, MD. "A Simple Guide to Reading and Understanding Practice Research."
Improving t he Effect iveness of t he Helping Professions: An Evidence-Based Approach t o Pract ice (n.d.): 1938. Columbia Universit y. Columbia, 19 Apr. 1999. Web. 2 Oct. 2016.

Hobbs, Richard, Ellen T. Murray, and Roger Holder. "Accuracy of Diagnosing Atrial Fibrillation on
Electrocardiogram by Primary Care Practitioners and Interpretative Diagnostic Software: Analysis of Data
from Screening for Atrial Fibrillation in the Elderly (SAFE) Trial." Brit ish Medical Journal. British Medical Journal,
23 Aug. 2007. Web. 2 Oct. 2016.
<http://www.bmj.com/content/335/7616/380?linkT ype=FULL&resid=335/7616/380&journalCode=bmj >.

UIChildrens. "What Is an Electrocardiogram (EKG)?" YouTube. YouTube, 19 Apr. 2012. Web. 10 Oct. 2016.
<https://www.youtube.com/watch?v=jxGdbaC8H68>.

"What Is an Electrocardiogram?" Nat ional Heart , Lung, and Blood Inst itute. USA.gov, 1 Oct. 2010. Web. 2 Oct.
2016. <https://www.nhlbi.nih.gov/health/health-topics/topics/ekg>.