心肌梗死ECG(精).ppt

* ECG Notes F.A. Davis Company Philadelphia 金山湖门诊部 何医师 编 Myocardial infarction Clinical Tip: Lead aVR is a nondiagnostic lead and does not show any change in an MI. Clinical Tip: An MI may not be limited to just one region of the heart. For example, if there are changes in leads V3 and V4 (anterior) and in I, aVL, V5, and V6(lateral), the MI is called an anterolateral infarction. ● Anterior MI Occlusion of the left coronary artery—left anterior descending branch ECG changes: ST segment elevation with tall T waves and taller-than-normal R waves in leads V3 and V4 ECG Notes F.A. Davis Company Philadelphia 金山湖门诊部 何医师 编 Inferior MI Occlusion of the right coronary artery—posterior descending branch ECG changes: ST segment elevation in leads II, III, and aVF ECG Notes F.A. Davis Company Philadelphia 何医师 编 lateral MI Occlusion of the left coronary artery—circumflex branch ECG changes: ST segment elevation in leads I, aVL, V5, and V6 Clinical Tip: Lateral MI is often associated with anterior orinferior wall MI. Be alert for changes that may indicate cardiogenic shock or congestive heart failure. ECG Notes F.A. Davis Company Philadelphia 何医师 编 Posterior MI Clinical Tip: Diagnosis may require a 15-lead ECG because a standard 12-lead does not look directly at the posterior wall. Occlusion of the right coronary artery (posterior descending branch) or the left circumflex artery Tall R waves and ST segment depression possible in leads V1,V2, V3, and V4 ST segment elevation in true posterior leads, V8and V9 ECG Notes F.A. Davis Company Philadelphia 何医师 编 Septal MI Occlusion of the left coronary artery—left anterior descending branch ECG changes: pathological Q waves；absence of normal R waves in leads V1 and V2 Clinical Tip: Septal MI is often associated with an anteriorwall