1. Postgraduate Education BS Physical Therapy, Silliman University, 1996 BS Zoology, MSU-Iligan Institute of Technology 1999 Doctor of Medicine, Mindanao State University-College of Medicine Post-graduate Internship University of the Philippines, Philippine General Hospital 2003-2004 Internal Medicine Residency University of the Philippines, Philippine General Hospital 2004-2007 Fellowship in Cardiology University of the Philippines, Philippine General Hospital 2008-2011 Affiliations Fellow, Philippine College of Physcians Fellow, Philippine Heart Association Diplomate, Philippine College of Cardiology JILL IRENE Z. CAPISTRANO MD, FPCP, DPCC

2. Dr. Jill Irene Z. Capistrano, FPCP,DPCC INTERNAL MEDICINE-CARDIOLOGY

3. P Q R T QT interval PR interval ST interval QRS interval S ST segment PR segment

5. Normal P wave morphology

6. Normal QRS Complex Morphology

7. Normal T wave morphology

9. Determination of Rhythm

14. Determination of Rate

15. v v Measurement of Rate

21. Determination of Axis

22. Standard Locations of Limb Leads III I II aVL aVR aVF

23. Determination of Axis Lead I Lead aVF

25. Chamber Enlargement

26. Standard Locations of Chest Leads

27. Atrial Enlargement

28. Atrial Enlargement II V1 B V1

30. Ventricular Enlargement

35. A 55F hypertensive sought consult at the ER for a blood pressure of 150/100. You requested for ancillary procedures, including an ECG.

36. Sinus rhythm, normal axis, left ventricular hypertrophy 13 X 2 S in V1 + R in V5 or V6 > 35mm LEFT VENTRICULAR HYPERTROPHY 20 X 2

37. A 24 year-old male with Atrial Septal Defect was admitted for shortness of breath.

38. Interval between QRS complex < 3major divisions 1500/# small squares = 1500/12 = 125 beats/min SINUS TACHYCARDIA

39. P waves tall and pointed in II and aVF RIGHT ATRIAL ENLARGEMENT QRS downward in lead I and upright in lead aVF RIGHT AXIS DEVIATION

40. Sinus tachycardia, right axis deviation, right atrial abnormality, right ventricular hypertrophy QRS upright in V1 RIGHT VENTRICULAR HYPERTROPHY Prominent S waves across precordial leads

42. LAE, RAE, RVH LAE P pulmonale RVH

43. Bundle Branch Block

52. A 24 year old female admitted for heart murmur.

53. Normal sinus rhythm, right bundle branch block QRS complex >120 msec Delayed intrinsicoid deflection time in V1 RIGHT BUNDLE BRANCH BLOCK Intrinsicoid deflection time

54. Normal sinus rhythm, right bundle branch block RSR’ in V1 Wide S waves in I, V6 RIGHT BUNDLE BRANCH BLOCK

55. A 50/M smoker diabetic admitted for pain.

56. Sinus rhythm, left bundle branch block Pseudoinfarct pattern in V1 Monophasic R / notched R in V6 LEFT BUNDLE BRANCH BLOCK

61. Myocardial ischemia and infarction

66. After 2days Several days or months First day First and second day Normal ECG Onset and first several hours

67. Occlusion of left descending coronary artery

69. Occlusion of left circumflex coronary artery

70. Occlusion of right coronary artery

77. Exercise ECGs

89. Thank You!