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1、ELECTROCARDIOGRAM,The Standard 12-lead Electrocardiogram,How to measure each wave:amplitude duration,25mm/s,ELECTROCARDIOGRAM,ECG records the changing potential of the field imparted by the heart.ECG dose not record directly the electrical activity of the heart.ECG record the electrical activity of
2、the heart from the body surface.,插入离子通道图片,Electrical basis and theory,Electrical basis and theory,depolarizationdipolerepolarization,Electrical basis and theory,Electrical basis and theory,q,Clinical electrocardiolopy elementary knowledge,VectorResultant vectorLoop,Electrical basis and theory,The St
3、andard 12-lead Electrocardiogram,SA nodeBachmannAV nodeHis bundleLeft and right branch of bundlePukinje fiber,The Standard 12-lead Electrocardiogram,P WaveP-R intervalQRS ComplexST segmentT WaveQ-T interval,The Standard 12-lead ElectrocardiogramR Wave form,Lead System of the ECG,Limb leads,Einthoven
4、 trigone,Hexaxial system,Lead System of the ECG,Chest leads,Chest leads,Lead System of the ECG,.ECG EVALUATION,The Standard 12-lead Electrocardiogram,How to measure each wave:amplitude duration,25mm/s,How to calculate the heart rate,Heart Rate=60/R-R duration,Mean QRS axis,Cardiac Rotation,.NORMAL E
5、CG,P Wave P-R Interval QRS complex J point ST Segment T Wave Q-T Interval U Wave,.NOMAL ECGP Wave,form：I、II、avF、V4-6 duration：0.12samplitude:Limb leads 0.25mV,Chest leads 0.20mV.,.NOMAL ECGP-R Interval,duration：0.12s0.20s.,.NOMAL ECGQRS complex,duration:0.060.10s.form and amplitude.R peak time Q Wav
6、e,.NOMAL ECG,J pointST Segment,T WaveQ-T IntervalU Wave,IV.The Abnormal ECG,Atrial and Ventricular hypertrophy,Atrial and Ventricular hypertrophy(一）atrial enlargment,Left atrial enlargement,Right atrial enlargement:,Atrial and Ventricular hypertrophy(一）left Ventricular enlargment,QRS voltage:R in V5
7、,62.5mV,RV5+SV13.5 or 4.0mV,RI1.5mV,R in aVL1.2mV,aVF2.0mV,S in V1 2.4mV,RI+SIII2.5mV.left axis deviation QRS duration0.09ms.ST segment and T wave,left Ventricular enlargment,Atrial and Ventricular hypertrophy(二）Right Ventricular enlargment,V1 lead R/S1,V5 lead R/S1.05mV.right axis deviation+90.ST-T
8、 change,Right Ventricular enlargment,Atrial and Ventricular hypertrophy(三）Biventricular enlargement,Approximately normal ECG.Left or Right Ventricular Hypertrophy ECGBiventricular Hypertrophy ECG,Biventricular enlargement,V.Ischemia and ST-T Segment,Forms:(1)Ischemia:a.subendocardial ischemia b.sube
9、picardial ischemia(2)Injury.,clinical significancedifferential diagnosis,Ischemia and ST-T Segment,Ischemia and ST-T Segment,Ischemia and ST-T Segment,Ischemia and ST-T Segment,VI.Myocardial Infarction,(一）Forms and mechanism1)ischemia2)infury3）infarction,VI.Myocardial Infarction,VI.Myocardial Infarc
10、tion,VI.Myocardial Infarction,VI.Myocardial Infarction,（二）Evolution of the infarction and duration the ECG1)initial phase2)acute phase3)subacute phase4)recovery phase,Myocardial Infarction,VI.Myocardial Infarction,The ECG and location of infarction,Myocardial Infarction,Myocardial Infarction,Nonspesific patterns of infarction,non-Q wave myocardial infarctioninfarction complicated with other diseasesdifferential diagnosis,
