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2014年4月24日 星期四

[EKG] 整理自 ECGs for the Emergency Physicians Part 1

1. LVH strain pattern:
(a) Lateral leads: STD & Asymmetric TWI
(b) Right precordial leads: STE

2. Prominent R wave in lead V1 (R/S-ratio > 1), D/dx:
(a) RVH
(b) RV-strain/dilatation
(c) HOCM
(d) Dextrocardia
(e) Ventricular ectopy
(f) WPW
(g) Misplaced precordial leads
(口訣: WORD)
W: WPW, O: HOCM, R: RVH/RV-strain/RBBB, D: Dextrocardia

3. Acute massive pulmonary embolism likely:
(a) Tachycardia
(b) RAD
(c) incomplete RBBB
(d) S1Q3T3
(e) TWI in inferior and anteroseptal leads

4. Cyclic antidepressant overdose likely:
(a) Tachycardia
(b) RAD
(c) R-wave in lead aVR > 3mm
(d) QRS-prolonged

5. HOCM likely: (以下findings都是ventricular septum hypertrophy所致)
(a) large QRS in ALL leads
(b) tall R-wave in lead V1 & V2
(c) deep Q-wave in INFERO-LATERAL leads

6. Digoxin toxicity likely:
(a) Occasional VPCs
(b) "Hockey-stick" like appearance of terminal portion of R-wave
(c) Complete heart block with regular junctional or ventricular escape
(d) Atrial tachycardia with variable AV-block

7. WPW mimicking as AMI
(a) INFERIOR leads有large Q-wave   ==> IMI
(b) V1有large R-wave                        ==> PMI