33 了解急性心肌梗塞 知道如何尋找— ST 升高 >1 mm 連續三個導程 J point plus 0.04 second PR baselineST-segment deviation = 4.5 mm
34 12導程心電圖變化Baseline缺血—tall or inverted T wave (infarct), ST segment may be depressed (angina)損傷—elevated ST segment, T wave may invert梗塞 (急性)—abnormal Q wave, ST segment may be elevated and T wave may be inverted梗塞 (時間不知）—abnormal Q wave, ST segment and T wave returned to normal
39 Acute myocardial infarction in the presence of left bundle branch block Features suggesting acute MIST changes in the same direction as the QRS (as shown here)ST elevation more than you'd expect from LBBB alone (e.g. > 5 mm in leads V1 - 3)Q waves in two consecutive lateral leads (indicating anteroseptal MI) (ref. Sgarbossa EB et al, N Engl J Med 1996;334:481-7)
42 Long Q-T intervalRomano-Ward syndrome is an autosomal dominantly inherited form of long QT interval and there is a risk of recurrent ventricular tachycardia, particularly Torsade de Pointes. Ventricular premature beats (VPBs)
43 Junctional rhythymThis is a recording from a a woman in her 50's with a long standing history of asthma and palpitations, she was on amiodarone at the time of the recording. The patient had just been converted from supraventricular tachycardia. The rhythm is regular, the QRS is narrow, and p waves are not clearly seen, except for a possible one at the beginning of the second QRS in the rhythm strip. This could be a sign of digitalis toxicity but this was not believed to be the case for this patient.