There are two ways that the movement of electrolytes across the cell membrane is increased. Although water and oxygen, for example, cross the cell membrane freely, the cell membrane has limited permeability to electrolytes ( Marieb and Hoehn, 2015). There is considerable interchange between the cells and the extracellular fluid. In the heart, the most important electrolytes are sodium, potassium and calcium ( Klabunde, 2012). It is the concentration of electrolytes, inside and outside the cell, and their ability to cross the cell membrane, that creates electrical activity in the cell. Both the cells and the surrounding fluid contain multiple substances including water, proteins and electrolytes. The body is composed of millions of individual cells, each enclosed by a fatty cell membrane and surrounded by extra-cellular fluid ( Alberts et al, 2010). This section will introduce you to a number of terms that are important if you wish to interpret and understand an ECG, such as resting potential, repolarisation, depolarisation and action potential. A firm grounding in basic cell physiology will help readers to understand how the heart works, and to appreciate the implications of findings on the ECG. It is important to develop a good understanding of the way in which our cells function. We will put forward the argument that ECGs can be understood by anyone with the time and patience to build the necessary knowledge. However, the premise of this series is that this doesn't have to be the case. ECGs are also useful in detecting non-cardiac pathology, for example, pulmonary emboli and electrolyte disorders ( Garcia, 2015).įrom many practitioners' perspective, ECGs are perceived as complex and difficult to understand-a ‘black art’ understood by the few ( Wetherell, 2013). ECGs are pivotal in the diagnosis of cardiac ischaemia and infarction, provide the evidence for pacemaker implantation, and detect inherited abnormalities such as cardiomyopathy and long-QT syndrome ( Jowett and Thompson, 2007). It also provides information about the health of the electrical system, the size of the heart chambers, and the supply of blood to the heart muscle ( Hampton, 2008). An ECG provides a measurement of the rate and rhythm of the heart. The ECG is an important screening tool that offers practitioners a wealth of information that can be used alongside the history and clinical findings ( Younker, 2011). This electrical activity is fundamental in coordinating the function of the heart, and it is this activity that ECG machines record and display. This first article will explore and discuss the anatomy and physiology of the heart's electrical system. ♦ Provide the reader with an understanding of the anatomy and physiology of the heart and conducting system. ♦ Explore why ECGs are important tools in the diagnosis and management of heart disease This is the first in a series of articles that will aim to: One of the reasons for this is a limited knowledge of ECG interpretation resulting from a lack of appropriate training ( Richley, 2013). Despite its widespread use, many people struggle to master the basics of ECG interpretation and errors in interpretation can lead to misdiagnosis and delays in appropriate treatment. One of the most important diagnostic tests is the 12-lead electrocardiogram (ECG) ( Society for Cardiological Science & Technology, 2014). It is important, therefore, that health-care practitioners develop their skills and knowledge in relation to this problem if patients are to obtain the best possible care in a timely manner. Cardiovascular disease is one of the main causes of death in the UK, and a common cause of hospital admission ( Bhatnagar et al, 2015).
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