CHAPTER 1. INTRODUCTION
The greatest progress to date in the use of computers for the clinical analysis of physiological data has occurred in the field of cardiology. There are several reasons for this; first of all, electrocardiogram (ECG) potentials are relatively easy to measure; secondly, the ECG is an extremely useful indicator for both screening and diagnosis. In addition, certain abnormalities of the ECG are quite well defined and can be readily identified. The ECG signal provides the following information of a human heart [1]: Impulse origin and propagation Drug effects on the heart Heart position and its relative chamber size Changes in electrolyte concentrations Extent and location of myocardial ischemia Heart rhythm
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The heart is a hollow muscle that is about the size of a fist. In one minute, it pumps about five liters (roughly five quarts) of blood through the body, it is made up of four chambers as shown in Figure 2 .1 Right Atrium (RA), Left Atrium (LA), Right Ventricle (RV), Left Ventricle (LV). An ECG is a diagnosis tool that reported the electrical activity of heart recorded by skin electrode. The morphology and heart rate reflects the cardiac health of human heart beat [16]. It is a noninvasive technique that means this signal is measured on the surface of human body which is used in identification of the heart diseases [17, 18]. Any disorder of heart rate or rhythm, or change in the morphological pattern, is an indication of cardiac arrhythmia which could be detected by analysis of the recorded ECG waveform. The amplitude and duration of the PQRS-T wave contains useful information about the nature of disease afflicting the heart. The electrical wave is due to depolarization and repolarization of Na+ and K ions in the blood [17]. Electrocardiography is considered to be one of the most powerful diagnostic tools in medicine that is routinely used for the assessment of the functionality of the heart. An ECG is the conventional method for noninvasive interpretation of the electrical activity of the heart in real-time. The electrical cardiac signals are recorded by an external device by attaching electrodes to the outer surface of the skin of the patient’s thorax. These currents stimulate the cardiac muscle and cause the contractions and relaxations of the heart. The electrical signals travel through the electrodes to the ECG device which records them as characteristic waves. Different waves reflect the activity of different areas of the heart which generate the respective flowing electrical currents. Figure 2.2
%% Init % clear all; close all; Fs = 4e3; Time = 40; NumSamp = Time * Fs; load Hd; x1 = 3.5*ecg(2700). ' ; % gen synth ECG signal y1 = sgolayfilt(kron(ones(1,ceil(NumSamp/2700)+1),x1),0,21); % repeat for NumSamp length and smooth n = 1:Time*Fs '; del = round(2700*rand(1)); % pick a random offset mhb = y1(n + del) '; %construct the ecg signal from some offset t = 1/
The American Society of Echocardiography (ASE) established
Generate: Heart auscultation is useful in characterizing heart sounds and identifying abnormalities that may suggest cardiac dysfunction.1 The fourth heart sound (S4 atrial gallop), heard during the patient’s physical examination, is often an abnormal finding due to reduction in ventricular wall compliance.1,2 Additionally, S4 occurs due to rapid deceleration of active blood flow due to a nondistensible ventricle.2 S4 can be heard in patients with hypertension, hypertrophic cardiomyopathy and acute myocardial infarction (AMI).1,2
5. Approach to the diagnosis. 5.1. Is it cardiac or not? 5.2.
Monitor the heart rate and pattern Mr. Roberts has already developed sinus tachycardia with short runs of ventricular tachycardia, ST-segment elevation, T-wave inversion, and the development of Q waves over most of the anterior V leads on his electrocardiogram. The ST-segment elevation and the T-wave inversion indicate a possible Myocardial Infarction The low serum levels of potassium due to fluid shifting back to the intracellular compartments, the myocardium excitability increases resulting in tachycardia and abnormal EKG patterns Monitor fluid status Weight the patient daily
Echocardiogram- This will show a graphic outline of the hearts movement. Doppler Ultrasound- To evaluate blood flow across the hearts
1. Atrial Fibrillation – It is an aggravation of the heart 's electrical framework. The issue begins in the upper chambers of the heart, which is the atria and causes these chambers to fibrillate, instead of beating normally. This means that the heart does not pump blood around the body as effectively as it should (Heart Foundation).
This type of shock occurs when the heart is unable to pump blood effectively. This is evident to patients who have had myocardial infarction, such as John’s case. In this illness, the heart has decreased contractility resulting to decreased cardiac output. Such decrease will stimulate the sympathetic nervous system to activate the compensatory mechanism by increasing the heart rate as evident in John’s vital sign to increase the peripheral pressure and ventricular
Conclusion: In conclusion, as doing a jump rope increased the heart beat per minute and as doing more numbers of exercise, that increased the heart rate even more. In the first graph above (Average initial heart rate VS Average heart rate after jumping), all the blue bars are below the green bars, this represent that no matter the amount of exercise, in all set, the heart rate anyway increased. The result showing in the first graph transformed into a second graph in order to show the changes of heart rate: In the second graph, the average change in heart rate is continually increasing as doing more numbers of jumps. The reason of why this relationship between the numbers of jumping and average change of heart rate is showing as increasing is because of heart beat and exercise are related.
This will help to narrow down the possible causes of death greatly, seeing how it is heart
In this regard, cardiovascular response to exercise occurs with changes in heart rate, cardiac output, stroke volume, peripheral vascular resistance and blood pressure/arterial pressure,
With this information, we can then conclude that the contraction of cardiac muscle tissue is an involuntary action. Cardiac muscle fibers themselves are organized in bundles that “swirl” in a slightly diagonal or oblique direction around the heart and when stimulated by the aforementioned, are responsible for the strong
A computerized tomography scan, also known as a CT scan, is a series of x-ray images taken from different angles, specifically referencing the coronary area. It uses computer processing to detect calcium deposits found in atherosclerotic plaque in the coronary arteries of heart disease patients. It generates three-dimensional snapshots of the blood vessels that surround the heart, as well as the heart itself (Levy, 2014). When CT scans were first invented by the British engineer, Godfrey Hounsfield, in 1972, the procedure was not effective on the cardiovascular system, as the heart is always in motion. In the early stages of the CT scan, it was only able to take 1-8 slices per minute, which is much slower than the rate of the heart.
Larsen, C.E., Trip, R., Johnson, C.R., 1996. Methods for procedures related to the electrophysiology of the heart. Nageswari, K.S., 2007. Handouts on cardiovascular system. Jaypee Brothers, New Delhi.