ECG（心电图）.ppt

Ⅰ Atrial enlargemen: （Ⅰ ） Right atrial enlargement （Ⅱ ） Left atrial enlargement （Ⅲ ） Biatrial enlargement Ⅱ Ventricular hypertrophy: （Ⅰ ） Left ventricular hypertrophy （Ⅱ ） Right ventricular hypertrophy （Ⅲ ） Biventricular hypertrophy Order of atrial depolarization is right first and left later right atrial depolarization period prolonged and overlap with left atrial depolarization period，but the overall depolarization period is not changed So electrocardiogram represent amplitud of atrial depolarization raise up （Ⅱ ） Left atrial enlargement Left atrial depolarization later Electrocardiogram represent the period of atrial depolarization Prolonged 1.p波宽，时间≥0.12 S，常呈双峰，峰距≥ 0.04S，在I、II、aVL导联明显。多见于二尖瓣狭窄，故称之为“二尖瓣型P波”。 2.PV1常呈先正后负波，负相波较深，将此负向波时间乘以该振幅，称为P波终末电势（Ptf），左房大时，PtfVI≥0.04mm . s。 Biatrial enlargement P wave widen more than 0.12s, amplitude more than 0.25mv P wave enlarge and diphasic in V1, amplitude larger than normal P pulmonale mitral P wave are not diagnostic Specificity of cor pulmonale Mitral valve disease Ⅱ Ventricular hypertrophy Ventricular hypertrophy caused by ventricular diastolic or systolic overloading; Indicate organic heart disease Ventricular hypertrophy resut in Myocardium depolarization increased voltage、Myocardium activation time prolongation、 changed repolarization order by the relative insufficiency of blood supply The more positive index the higher the diagnostic reliability Electrocardiogram diagnosis has limitations （Ⅱ ） Right ventricular hypertrophy produces changes in the QRS complex,ST,T R waves in leads facing the right ventricle are taller than normal： V1、 avR. S waves in leads facing the left ventricle are deeper than normal：Ⅰ,avl, V5. （Ⅲ ） Biventricular hypertrophy 1. normal ECG 2. one ventricular hypertrophy ECG 3. biventricular hypertrophy ECG Review Questions Diagnostic criteria of atrial enlargement ventricular hypertrophy Thanks！