《临床实用心电图实例分析与解读》心电图基本能力
Published at: September 05, 2014 2014年第1卷第33期
关键词:
心电图基本能力
ECG描记正常
- 正常ECG
技术问题
- 导联错误
- 干扰
窦性心律/窦性心律失常
- 窦性心律
- 窦性心动过速
- 窦性心动过缓
- 窦性心律失常
- 窦性停搏
- 窦房阻滞, Ⅰ型
- 窦房阻滞, Ⅱ型
其他室上性心律失常
- 房性期前收缩(未下传)
- 房性期前收缩(正常传导)
- 房性期前收缩(伴差异传导)
- 异位房性心律或房速(单点)
- 多点房性心律或房速
- 心房纤颤
- 心房扑动
- 交界性期前收缩
- 交界性逸搏及交界性逸搏心律
- 加速性交界性逸搏心律
- 交界性心动过速
- 阵发性室上性心动过速
室性心律失常
- 室性期前收缩
- 室性逸搏及室性逸搏心律
- 室性心动过速(单型)
- 室性心动过速(多型或尖端扭转型室速)
- 心室颤动
房室传导
- 1度房室传导阻滞
- 2度Ⅰ型房室传导阻滞(文氏型)
- 2度Ⅱ型房室传导阻滞(莫氏型)
- 高度房室传导阻滞
- 3度房室传导阻滞(伴交界性逸搏心律)
- 3度房室传导阻滞(伴室性逸搏心律)
- 房室分离(逸博)
- 房室分离(夺获)
- 房室分离(房室传导阻滞伴逸搏)
室内传导
- 完全性左束支传导阻滞(持续或一过性)
- 不完全性左束支传导阻滞
- 完全性右束支传导阻滞(持续或一过性)
- 不完全性右束支传导阻滞
- 左前分支阻滞(LAFB)
- 左后分支阻滞(LPFB)
- 非特异性室内传导延缓(IVCD)
- 预激综合征(WPW)
QRS电轴与电压
- 电轴右偏(+90°至+180°)
- 电轴左偏(-30°至-90°)
- 奇异电轴(-90°至-180°)
- 不确定的电轴
- 肢体导联低电压(<0.5 mV)
- 胸导联低电压(<1.0 mV)
肥厚/增大
- 左房增大
- 右房增大
- 双房增大
- 左室肥大
- 右室肥大
- 双室肥大
ST-T异常, U波异常
- 早期复极(正常变异)
- 非特异性ST-T 异常
- ST段抬高(透壁性损伤)
- ST段抬高(心包炎)
- 对称性T波倒置
- 超急性T波
- 显著直立的U波
- U波倒置
- Q-T间期延长
心肌梗死(急性, 近期, 陈旧)
- 前壁梗死
- 下后壁梗死
- 后壁梗死
- 前间壁梗死
- 前壁梗死
- 前侧壁梗死
- 广泛前壁梗死
- 高侧壁梗死
- 非Q波梗死
- 右室梗死
临床问题
- 慢性阻塞性肺疾病
- 低血钾
- 高血钾
- 低钙血症
- 高钙血症
- 地高辛作用
- 地高辛中毒
- 中枢神经系统病变
起搏ECG
- 心房起搏心律
- 心室起搏心律
- 房室顺序起搏心律
Basic Competency in Electrocardiography
NORMAL TRACING
- Normal ECG
TECHNICAL PROBLEM
- Lead misplaced
- Artifact
SINUS RHYTHMS/ARRHYTHMIAS
- Sinus rhythm
- Sinus tachycardia
- Sinus bradycardia
- Sinus Arrhythmia
- Sinus arrest or pause
- Sinoatrial block, type I
- Sinoatrial block, type II
OTHER SV ARRHYTHMIAS
- PAC’s (nonconducted)
- PAC’s (conducted normally)
- PAC’s (conducted with aberration)
- Ectopic atrial rhythm or tachycardia (unifocal)
- Multifocal atrial rhythm or tachycardia
- Atrial fibrillation
- Atrial flutter
- Junctional prematures
- Junctional escapes or rhythms
- Accelerated Junctional rhythms
- Junctional tachycardia
- Paroxysmal supraventricular tachycardia
VENTRICULAR ARRHYTHMIAS
- PVC’s
- Ventricular escapes or rhythm
- Accelerated ventricular rhythm
- Ventricular tachycardia (uniform)
- Ventricular tachycardia (polymorphous or torsades)
- Ventricular fibrillation
AV CONDUCTION
- 1st degree AV block
- Type I 2nd degree AV block (Wenckebach)
- Type II 2nd degree AV block (Mobitz)
- AV block, advanced (high grade)
- 3rd degree AV block (junctional escape rhythm)
- 3rd degree AV block (ventricular escape rhythm)
- AV dissociation (default)
- AV dissociation (usurpation)
- AV dissociation (AV block)
INTRAVENTRICULAR CONDUCTION
- Complete LBBB, fixed or intermittent
- Incomplete LBBB
- Complete RBBB, fixed or intermittent
- Incomplete RBBB
- Left anterior fascicular block (LAFB)
- Left posterior fascicular block (LPFB)
- Nonspecific IV conduction delay (IVCD)
- WPW preexcitation pattern
QRS AXIS AND VOLTAGE
- Right axis deviation (+90° to +180°)
- Left axis deviation (-30° to -90°)
- Bizarre axis (-90° to -180°)
- Indeterminate axis
- Low voltage frontal plane (<0.5 mV)
- Low voltage precordial (<1.0 mV)
HYPERTROPHY/ENLARGEMENTS
- Left atrial enlargement
- Right atrial enlargement
- Biatrial enlargement
- Left ventricular hypertrophy
- Right ventricular hypertrophy
- Biventricular hypertrophy
ST-T, AND U ABNORMALITIES
- Early repolarization (normal variant)
- Nonspecific ST-T abnormalities
- ST elevation (transmural injury)
- ST elevation (pericarditis pattern)
- Symmetrical T wave inversion
- Hyperacute T waves
- Prominent upright U waves
- U wave inversion
- Prolonged QT interval
MI PATTERNS (acute, recent, old)
- Interior MI
- Inferoposterior MI
- Inferoposterolateral MI
- Posterior MI
- Anteroseptal MI
- Anterior MI
- Anterolateral MI
- Extensive anterior MI
- High lateral MI
- Non Q-wave MI
- Right ventricular MI
CLINICAL DISORDERS
- Chronic pulmonary disease pattern
- Suggests hypokalemia
- Suggests hyperkalemia
- Suggests hypocalcemia
- Suggests hypercalcemia
- Suggests digoxin effect
- Suggests digoxin toxicity
- Suggests CNS disease
PACEMAKER ECG
- Atrial-paced rhythm
- Ventricular paced rhythm
- AV sequential paced rhythm
- Failure to capture (atrial or ventricular)
- Failure to inhibit (atrial or ventricular)
- Failure to pace (atrial or ventricular)