ECG in the Child and Adolescent - part 7 ppsx

P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.22 S amplitude by age in lead V1 0 0.25 0.5 0.75 1 1.25 1.5 1.75 2 2.25 2.5 2.75 3 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 S Amplitude in Millivolts 95% 75% 50% 25% 5% Age, days Age, months Age, years Figure 3.22 S amplitude by age in lead V1, each curve corresponding to the indicated percentile level (• = mean). S waves in lead V1 are small or absent after birth, increasing their depth little during infancy, then are more prominent thereafter until age 13–18 years. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 0.91 0.71 0.59 0.40 0.44 0.85 0.81 1.08 1.14 1.35 1.35 1.67 Mean 0.36 0.24 0.23 0.19 0.18 0.32 0.36 0.57 0.59 0.7 0.73 0.84 (±SD) 0.32 0.17 0.21 0.14 0.16 0.23 0.28 0.33 0.32 0.41 0.35 0.44 5% 0.1 0.0 0.1 0.0 0.0 0.1 0.0 0.2 0.1 0.1 0.2 0.2 (N) 109 128 95 100 120 92 97 113 107 100 289 510 42 P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.23 S amplitude by age in lead V2 0 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 S Amplitude in Millivolts 95% 75% 50% 25% 5% Age, yearsAge, months Age, days Figure 3.23 S amplitude by age in lead V2, each curve corresponding to the indicated percentile level (• = mean). S waves deflection in V2 decreases slightly after birth until age 1–3 months. From this age on, the deflection increases, but very little, until adolescence. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 2.79 2.67 2.05 1.94 1.77 1.83 2.04 2.24 2.21 2.30 2.34 2.56 Mean 1.66 1.54 1.22 1.18 0.97 1.06 1.25 1.25 1.27 1.28 1.32 1.41 (±SD) 0.59 0.69 0.47 0.49 0.41 0.48 0.57 0.60 0.63 0.56 0.61 0.64 5% 0.66 0.25 0.40 0.35 0.43 0.32 0.44 0.38 0.43 0.40 0.35 0.48 (N) 109 128 95 100 120 92 97 113 107 100 289 510 43 P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.24 S amplitude by age in lead V4 0.00 0.50 1.00 1.50 2.00 2.50 S Amplitude in Millivolts 95% 75% 50% 25% 5% 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 Age, years Age, months Age, days Figure 3.24 S amplitude by age in lead V4, each curve corresponding to the indicated percentile level (• = mean). S waves in V4 are prominent after birth, and become shallower and less prominent thereafter until age 13–18 years. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 2.11 1.84 1.40 1.51 1.28 1.46 1.64 1.22 1.40 1.27 1.23 1.16 Mean 1.13 1.01 0.91 0.83 0.70 0.76 0.82 0.53 0.65 0.56 0.56 0.47 (±SD) 0.59 0.46 0.37 0.36 0.34 0.47 0.49 0.38 0.58 0.41 0.43 0.35 5% 0.16 0.25 0.35 0.35 0.21 0.10 0.17 0.06 0.03 0.00 0.00 0.01 (N) 109 128 95 100 120 92 97 113 107 100 289 510 44 P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.25 S amplitude by age in lead V5 -0.2 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 S Amplitude in Millivolts 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 95% 75% 50% 25% 5% Age, years Age, months Age, days Figure 3.25 S amplitude by age in lead V5, each curve corresponding to the indicated percentile level (• = mean). S waves are present after birth, becoming shallower gradually thereafter until adolescence. The changing patterns are quite comparable to those of lead V4. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 1.46 1.42 1.03 1.11 0.90 1.03 1.08 0.69 0.91 0.77 0.80 0.68 Mean 0.72 0.72 0.63 0.60 0.46 0.51 0.53 0.3 0.39 0.33 0.29 0.28 (±SD) 0.43 0.40 0.28 0.28 0.25 0.35 0.33 0.22 0.37 0.26 0.26 0.22 5% 0.12 0.10 0.23 0.17 0.09 0.07 0.09 0.03 0.00 0.00 0.00 0.00 (N) 109 128 95 100 120 92 97 113 107 100 289 510 45 P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.26 S amplitude by age in lead V6 -0.2 0 0.2 0.4 0.6 0.8 1 1.2 S Amplitude in Millivolts 95% 75% 50% 25% 5% 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 Age, years Age, months Age, days Figure 3.26 S amplitude by age in lead V6, each curve corresponding to the indicated percentile level (• = mean). S waves in V6 are prominent after birth, and their amplitude decreases gradually along with increasing age until adolescence. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 1.09 1.04 0.83 0.69 0.62 0.64 0.69 0.47 0.53 0.50 0.56 0.50 Mean 0.47 0.47 0.43 0.38 0.27 0.26 0.31 0.17 0.23 0.2 0.18 0.18 (±SD) 0.32 0.35 0.23 0.21 0.20 0.21 0.23 0.16 0.26 0.15 0.17 0.16 5% 0.01 0.04 0.10 0.06 0.01 0.01 0.03 0.00 0.00 0.00 0.00 0.00 (N) 109 128 95 100 120 92 97 113 107 100 289 510 46 P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.27 T amplitude by age in lead I -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 0.35 0.40 0.45 0.50 T Amplitude in Millivolts 95% 75% 50% 25% 5% 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 Age, years Age, months Age, days Figure 3.27 T amplitude by age in lead I, each curve corresponding to the indicated percentile level (• = mean). T waves in lead I are small, absent, or even negative, shortly after birth and their amplitude increases gradually, reaching a plateau by age 3–6 months, and stays little changed until adolescence. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 0.14 0.20 0.24 0.28 0.36 0.41 0.43 0.39 0.40 0.42 0.41 0.39 Mean 0.07 0.11 0.16 0.19 0.23 0.28 0.27 0.28 0.27 0.28 0.27 0.24 (±SD) 0.05 0.06 0.07 0.06 0.07 0.08 0.10 0.05 0.05 0.08 0.09 0.08 5% −0.02 0.04 0.07 0.11 0.11 0.16 0.13 0.17 0.15 0.18 0.17 0.13 (N) 109 128 95 100 113 91 97 113 107 99 289 510 47 P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.28 T amplitude by age in lead II 0.00 0.10 0.20 0.30 0.40 0.50 0.60 T Amplitude in Millivolts 95% 75% 50% 25% 5% 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 Age, years Age, months Age, days Figure 3.28 T amplitude by age in lead II, each curve corresponding to the indicated percentile level (• = mean). T waves are small after birth. The T waves amplitude increases rapidly after age 3–7 days to age 3–6 months, then gradually thereafter up to 3–6 years of age. It decreases slightly after age 9–13 years until age 13–18 years. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 0.17 0.19 0.19 0.27 0.41 0.47 0.50 0.47 0.50 0.51 0.54 0.51 Mean 0.09 0.09 0.10 0.17 0.25 0.29 0.32 0.32 0.34 0.34 0.34 0.31 (±SD) 0.05 0.06 0.06 0.07 0.09 0.11 0.12 0.11 0.11 0.12 0.09 0.12 5% 0.00 0.01 0.02 0.05 0.11 0.15 0.15 0.18 0.16 0.12 0.15 0.12 (N) 109 128 95 100 113 91 97 113 107 99 289 510 48 P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.29 T amplitude by age in lead III -0.25 -0.20 -0.15 -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 T Amplitude in Millivolts 95% 75% 50% 25% 5% 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 Age, years Age, months Age, days Figure 3.29 T amplitude by age in lead III, each curve corresponding to the indicated percentile level (• = mean). T waves changes in lead III during the newborn period are very characteristic. The T amplitude decreases even becomes negative, reaching a nadir at age 3–7 days. It increases thereafter, up to a plateau by age 6–12 months until adolescence. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 0.13 0.07 0.03 0.09 0.18 0.23 0.18 0.16 0.21 0.20 0.24 0.25 Mean 0.03 −0.02 −0.06 −0.01 0.04 0.03 0.06 0.04 0.06 0.05 0.07 0.06 (±SD) 0.05 0.06 0.07 0.07 0.07 0.11 0.09 0.05 0.11 0.10 0.09 0.11 5% −0.08 −0.10 −0.18 −0.15 −0.09 −0.14 −0.11 −0.08 −0.10 −0.09 −0.09 −0.10 (N) 109 128 95 100 113 91 97 113 107 99 289 510 49 P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.30 T amplitude by age in lead aVR -0.5 -0.5 -0.4 -0.4 -0.3 -0.3 -0.2 -0.2 -0.1 -0.1 0.0 T Amplitude in Millivolts 95% 75% 50% 25% 5% 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 Age, years Age, months Age, days Figure 3.30 T amplitude by age in lead aVR, each curve corresponding to the indicated percentile level (• = mean). The T waves in lead aVR are always inverted. The depth of the T waves steadily increases after birth until age 3–6 months, and stays unchanged afterward until adolescence. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 0.0 0.0 −0.1 −0.1 −0.1 −0.2 −0.2 −0.2 −0.2 −0.2 −0.2 −0.1 Mean −0.07 −0.1 −0.12 −0.18 −0.23 −0.29 −0.29 −0.29 −0.3 −0.31 −0.3 −0.27 (±SD) 0.05 0.06 0.05 0.05 0.07 0.08 0.09 0.05 0.05 0.10 0.09 0.09 5% −0.2 −0.2 −0.2 −0.3 −0.4 −0.4 −0.4 −0.4 −0.4 −0.5 −0.5 −0.4 (N) 109 128 95 100 120 92 97 113 107 100 289 510 50 P1: FAW/SPH P2: FAW/SPH QC: FAW/SPH T1: FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.31 T amplitude by age in lead aVL -0.10 -0.05 0.00 0.05 0.10 0.15 0.20 0.25 0.30 T Amplitude in Millivolts 95% 75% 50% 25% 5% 0-1 1-3 3-7 7-30 1-3 3-6 6-12 1-3 3-6 6-9 9-13 13-18 Age, years Age, months Age, days Figure 3.31 T amplitude by age in lead aVL, each curve corresponding to the indicated percentile level (• = mean). The T waves amplitude in aVL increases after birth reaching a plateau at age 3–7 days, then increases slightly with a wider range, at age 3–6 months and thereafter. Days Months Years Age 0–1 1–3 3–7 7–30 1–3 3–6 6–12 1–3 3–6 6–9 9–13 13–18 95% 0.10 0.13 0.20 0.21 0.20 0.24 0.24 0.22 0.22 0.23 0.22 0.22 Mean 0.03 0.07 0.11 0.10 0.10 0.14 0.11 0.12 0.1 0.12 0.1 0.09 (±SD) 0.05 0.06 0.06 0.05 0.07 0.08 0.08 0.05 0.05 0.05 0.09 0.07 5% −0.08 −0.01 0.02 0.03 −0.01 −0.01 −0.01 0.03 0.00 0.01 0.00 −0.02 (N) 109 128 95 100 120 92 97 113 107 100 289 510 51 . FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.30 T amplitude by age in lead aVR -0 .5 -0 .5 -0 .4 -0 .4 -0 .3 -0 .3 -0 .2 -0 .2 -0 .1 -0 .1 0.0 T Amplitude in Millivolts 95% 75 % 50% 25% 5% 0-1 1-3 3 -7 7- 3 0 1-3 3-6 . FAW BLUK054-Lue June 19, 2006 13:44 CHAPTER 3.22 S amplitude by age in lead V1 0 0.25 0.5 0 .75 1 1.25 1.5 1 .75 2 2.25 2.5 2 .75 3 0-1 1-3 3 -7 7- 3 0 1-3 3-6 6-1 2 1-3 3-6 6-9 9-1 3 1 3-1 8 S Amplitude in Millivolts 95% 75 % 50% 25% 5% Age,. in Millivolts 0-1 1-3 3 -7 7- 3 0 1-3 3-6 6-1 2 1-3 3-6 6-9 9-1 3 1 3-1 8 95% 75 % 50% 25% 5% Age, years Age, months Age, days Figure 3.25 S amplitude by age in lead V5, each curve corresponding to the