临床医学]心电图讲座.ppt

急诊科常见心电图 及救治原则,常规心电图的波形组成和测量示意图,心脏特殊传导系统示意图,QRS波群的命名示意图,心绞痛与心肌梗死,心肌梗塞定位诊断,男，47岁,胸痛,缓解,急性下壁心肌梗塞,急性下壁心肌梗塞、陈旧前壁心肌梗塞,急性前间壁心肌梗塞,急性广泛前壁心肌梗塞,急性下壁心肌梗塞伴右束支传导阻滞,A 50 year old man with chest pain for 24 hours,A 55 year old man with 4 hours of “crushing“ chest pain,A 63 year old woman with 10 hours of chest pain and sweating,A 60 year old woman with 3 hours of chest pain.,AMI救治原则,镇静止痛,溶栓治疗,介入治疗,药物治疗,并发症的防治,房扑与房颤,心房扑动,心房扑动,心房扑动,心房颤动,心房颤动,A 47 year old man with a long history of palpitations and, lately, blackouts,房颤/房扑的救治原则,减慢心室率,转复心律,病因治疗,并发症的防治,药物转复 电转复,缓慢性心律失常,交界区逸搏,图示：箭头指房性早搏未下传 E指交界区逸搏（Escape）,室性逸搏,图示：箭头指宽大畸形的室性逸搏,室性逸搏心律+三度AVB,典型表现： 1、P波与QRS波群无关，P波频率（60bpm） QRS频 率，PP间隔与RR间隔各自规则 2、QRS波群宽大畸形，倒置T波，为室性逸搏心律,A 68 year old lady on digoxin complaining of lethargy.,A 73 year old woman with dizziness,A 70 year old man with exercise intolerance,Complete Heart Block,救治原则,药物治疗,起搏器治疗,阿托品 异丙肾上腺素,有症状,病因治疗/观察,无症状,室上性心动过速,A 76 year old man with breathlessness,An 57 year old lady with palpitations,SVT救治原则,药物转复,食道调博,手术治疗,射频消融术,异博定 心律平 ATP 胺碘酮 非药物治疗,室速与室颤,心室扑动,心室颤动,A 45 year old lady with palpitations and history of chronic renal failure,A 69 year old man 2 weeks after an inferior myocardial infarction,A 60 year old man with Ischaemic Heart Disease,A 36 year old lady with recurrent blackouts,A 60 year old man with 2 hours of “crus