专题介绍

《临床实用心电图实例分析与解读》心电图基本能力

Published at: 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)

 

 

 

comments powered by Disqus

附件