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Ebook ECG from basics to essentials - Step by step: Part 2

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Nội dung chi tiết: Ebook ECG from basics to essentials - Step by step: Part 2

Ebook ECG from basics to essentials - Step by step: Part 2

CHAPTER 9rACUTEPERICARDITIS\y*Clinical stages*Other conditions with similar features*Differential diagnosis*Early repolarizationECG from Eanci io Eite

Ebook ECG from basics to essentials - Step by step: Part 2enliob: Step by Sup. First Edition. Roland X- Stroobandl. s. Serge Harold and Aliens E Siniuevc. Published 2016 ê 2016 by lohn Wiley Sr Sons. lid. Com

panion Websate. www.wilcyxoaVgoistroobandVccgACUTE PERICARDITIS 1^1ECG changes in acute pericarditis mainly indicate inflammation of the epicardium (t Ebook ECG from basics to essentials - Step by step: Part 2

he layer directly surrounding the heart). The ECG is useful in the diagnosis of acute pericarditis, with abnormalities found in approximately 90% of c

Ebook ECG from basics to essentials - Step by step: Part 2

ases. Not all cases of pericarditis include each of the four stages shown betow. In fad, all four stages are present in only 50% oi patients or less.S

CHAPTER 9rACUTEPERICARDITIS\y*Clinical stages*Other conditions with similar features*Differential diagnosis*Early repolarizationECG from Eanci io Eite

Ebook ECG from basics to essentials - Step by step: Part 2elops secondary to pericardial inflammation. The ST elevation occurs during the first few days of pericardial inflammation and is mainly characterized

by diffuse upward concavity (saddle-shaped). ST segment elevation is usually loss than 5 mm with concordance of tho T wave. ST elevation invokes the Ebook ECG from basics to essentials - Step by step: Part 2

limb leads and precordial loads with reciprocal ST segment depression only in aVR and VtThis limited change in aVR and V1 represents a lack of substan

Ebook ECG from basics to essentials - Step by step: Part 2

tial reciprocal changes corresponding to the extensive ST elevation. PR segment depression that may bo subtle (1 mm or so) may occur in all the leads

CHAPTER 9rACUTEPERICARDITIS\y*Clinical stages*Other conditions with similar features*Differential diagnosis*Early repolarizationECG from Eanci io Eite

Ebook ECG from basics to essentials - Step by step: Part 2ite in direction.The PR changes are very specific and may be earliest manifestation of pericarditis The ECG may show low voltage (i.e. decreased ampli

tude of the QRS complexes) and there are no Q waves This stage may last up to two weeks.Stage II:Normalization of ST and PR deviations: T wave flatten Ebook ECG from basics to essentials - Step by step: Part 2

ing. This stage lasts from days to several weeks.Stage III:Diffuse T wave Inversion. This stage begins at the end of the second or third week and last

Ebook ECG from basics to essentials - Step by step: Part 2

s several weeks (these changes may not be present in all patients).Stage IV:Gradual resolution of T wave inversion that may last up to three months. A

CHAPTER 9rACUTEPERICARDITIS\y*Clinical stages*Other conditions with similar features*Differential diagnosis*Early repolarizationECG from Eanci io Eite

Ebook ECG from basics to essentials - Step by step: Part 2y may cause total electrical altemans1The ST segment elevation in acute pericarditis is usually ■concave", compared with the• convex" appearance of th

e ST segment in the acute injury stage of a myocardial infarction (Ml).2The widespread ST segment elevation does not correspond with any specific arte Ebook ECG from basics to essentials - Step by step: Part 2

rial territory. which usually occurs with acute Ml.3Reciprocal changes are absent in acute pericarditis, but frequent with acute Ml.DIFFERENTIAL DIAGN

Ebook ECG from basics to essentials - Step by step: Part 2

OSISOther conditions may have ECG features similar to those ol acute pericarditis. These conditions most commonly include myocardial infarction and ea

CHAPTER 9rACUTEPERICARDITIS\y*Clinical stages*Other conditions with similar features*Differential diagnosis*Early repolarizationECG from Eanci io Eite

Ebook ECG from basics to essentials - Step by step: Part 2T segment that occurs during the acute injury stage of a myocardial infarction. The widespread ST segment elevation does not correspond with any speci

fic arterial territory, which usually occurs with territorial distribution in acute myocardial infarction. Also, obvious reciprocal changes are absent Ebook ECG from basics to essentials - Step by step: Part 2

in acute pericarditis, although they are frequently found with acute myocardial infarction. Another feature that may aid in differentiating acute per

Ebook ECG from basics to essentials - Step by step: Part 2

icarditis from acute myocardial infarction is the absence of T wave inversion at the time of ST segment elevation in pericarditis. Such a change class

CHAPTER 9rACUTEPERICARDITIS\y*Clinical stages*Other conditions with similar features*Differential diagnosis*Early repolarizationECG from Eanci io Eite

Ebook ECG from basics to essentials - Step by step: Part 2ay generate Q waves or loss of R wave voltage in the precordial loads.ST segment height = 1 mmT wave height = 6 mmST/T wave ratio = 0.16ST/T < 0.25 is

consistent with ERi . ■ X -A-Li H . I i ỀIỂ i Mil I I-1 I I I IST segment height = 15 mmT wave height = 3.5 mmST n wave ratio = 0.43ST IT > 0.25 is c Ebook ECG from basics to essentials - Step by step: Part 2

onsistent with pericarditis

CHAPTER 9rACUTEPERICARDITIS\y*Clinical stages*Other conditions with similar features*Differential diagnosis*Early repolarizationECG from Eanci io Eite

CHAPTER 9rACUTEPERICARDITIS\y*Clinical stages*Other conditions with similar features*Differential diagnosis*Early repolarizationECG from Eanci io Eite

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