Đang chuẩn bị nút TẢI XUỐNG, xin hãy chờ
Tải xuống
(BQ) Continued part 1, part 2 of the document Electrocardiograph and cases of critical has contents: The electrocardiography of shortness of breath, confusing conditions - ST segment depressions and T-Wave inversions, confusing conditions - ST segment elevations and tall T-Waves (coronary mimics). Invite you to refer. | Chapter The Electrocardiography of Shortness of Breath 5 Key Points There are at least three common shortness of breath emergencies - pulmonary thromboembolism pericardial effusion and myocarditis - where the ECG often provides the first diagnostic information. While the ECG is not the definitive test for any of these conditions the ECG is often the first test performed. In many cases the ECG provides unmistakable clues that can guide initial treatment and further diagnostic testing. Pulmonary embolism PE is a common cause of dyspnea. The most common ECG abnormalities are sinus tachycardia T-wave inversions in leads V1 V2 and V3 a rightward QRS axis or an axis that is more rightward than normal for the patient s age the S1-Q3-T3 pattern and an rSR pattern in lead V1. Atrial flutter and atrial fibrillation occur less commonly. Concurrent T-wave inversions in the anterior and inferior leads are a vital clue to the presence of acute PE however these T-wave inversions are often misinterpreted by clinicians and computer algorithms as possible anterior ischemia possible inferior ischemia. In patients with acute PE anterior T-wave inversions an rSR complex in V1 and acute right axis deviation are markers of acute pulmonary hypertension and right heart strain. They are associated with more severe pulmonary hypertension right ventricular dysfunction extensive pulmonary vascular obstruction clot burden and mortality. Myocarditis often presents with dyspnea as well as chest pain palpitations and frequently signs of congestive heart failure. Classically a viral prodrome is present. The combination of low voltage in the limb or precordial leads and sinus tachycardia should raise the suspicion of acute myocarditis. The ECG may also demonstrate diffuse ST- and T-wave changes including ST-segment elevations ST-segment depressions T-wave inversions premature atrial or ventricular beats and conduction abnormalities. Echocardiography is frequently the key test that defines the global
