我的網誌清單

2013年5月14日 星期二

[EKG] Differential Diagnosis

Leftward Axis Deviation
1. Pacemaker
2. WPW
3. Inferior MI
4. LVH
5. LBBB
6. LAFB
7. Hyperkalemia
8. (Normal variant)

Rightward Axis Deviation
1. Lateral MI
2. WPW
3. RVH
4. LPFB
5. Pulmonary embolism
6. COPD
7. Na-channel blocker
8. Septal defect
9. Hyperkalemia

Wide QRS
1. BBB
2. WPW
3. Pacemaker rhythm
4. Na-channel blocker
5. LVH
6. Ventricular ectopic
7. Hyperkalemia or Acidosis

Short QT
1. Hypercalcemia
2. Digoxin Toxicity
3. (Congenital)

QTc-Prolongation
1. Electrolyte imbalance: HYPO-(K, Ca, Mg)
2. IICP
3. Medication: type Ia (quinidine, procainamide), type III (amiodaraone)
4. Hypothermia
5. (Congenital)

T-wave Inversion
1. WPW
2. Hypokalemia
3. CAD
4. Abnormal repolarization: BBB, pacemaker, ventricular hyperthrophy
5. ICH
6. Pulmonary disease: Pul. HTN, Hyperventilation, Pneumonia, Pul. embolism

ST-Elevation
1. STEMI
2. Peri-/myocarditis
3. LVH
4. LBBB
5. Ventricular aneurysm
6. Brugada
7. Hyperkalemia
8. CNS-effect (SAH)
9. Benign early repolarization
(口訣: LAP BAND)
LVH,LBBB / AMI / Pericarditis / Brugada,BER /Aneurysm(LV) / Neurological (SAH) / Drugs(cocaine)

ST-Depression
1. NSTEMI
2. Strain (due to ventricular hypertrophy)
3. Digitalis effect
4. Ischemia
5. Hypokalemia

Low-voltage 
definition:(QRS的amplitude): (a) lead (I + II + III) < 15 mm, or  (b) lead (V1 + V2 + V3) < 30 mm
1. "low power"
(a) Myxedema
(b) Cardiomyopathy
(c) Infiltrative disease (Sarcoidosis)
2. "blocked conduction"
(a) (air) COPD
(b) (fluid) pericardial/ pleural effusion
(c) (fat) obesity