Ver el código de «ECG (peds)»

{{Peds top}} [[ECG (main)]]
==Ventricular rate==
*Younger/smaller --> higher metabolic rate + lower vagal tone --> faster HR
[[File:Peds HR.png|thumb|]]

==Axis==
*Right axis ''normal'' in first 6 months of life
**Blood shunted away from pulm vasculature in utero, higher pulmonary pressures--> relatively thicker RV --> Right axis
*Extreme superior axis
**Axis of -90 - 180 degrees
**Seen with AV canal or atrial septal defects
*AVF lead vector
**Negative QRS vector in AVF seen in some cardiac malformations (e.g. AV septal defects, single ventricle
**Biphasic QRS in AVF can be normal but should be reviewed by peds cards cardiology review. [Evans, 2010]
[[File:QRS axis.png|thumb|]]


==Intervals==
*Age dependant norms
*Smaller muscle mass--> shorter PR
*QTc longer in infants <6mo
[[File:Intervals.png|thumb|]]


==T-wave inversions==
*T-wave inversions in anterior precordial leads are normal 
*T-waves upright in most leads for first 7 days of life
*T-waves typically inverted from 7 days to adolescence
*Once an individual child's T-waves flip upright, they should stay that way (i.e. to become newly inverted again would be pathologic)


==Voltage/Ventricular hypertrophy==
*Smaller pediatric chest wall --> EKG leads closer to heart --> exagerated voltages
**V2-V5 most likely to appear high voltage
**EKG auto-interpretations may "over-report" left or right ventricular hypertrophy
*LVH (quick/dirty method)
**If R of V6 intersects with baseline of V5--> abnormal
*RVH indicators
**Upright T-wave in V1 after 7 days of life
**If RSR' present; R' taller than R wave 
**Pure R wave in V1 in child >6mo
[[File:Voltage RVH-LVH.png|thumb|]]


==See Also==
*[[EKG]]
*[[Congenital heart disease]]
*[[PALS (Main)]]

==External Links==
*https://pedemmorsels.com/pediatric-ecg/
*https://litfl.com/paediatric-ecg-interpretation-ecg-library/

==References==
<references/>
[[Category:Pediatrics]]
[[Category:Cardiology]]