中国医科大学：《诊断学》课程教学课件（PPT讲稿）ECG-arrhythmia

I.Sinus Rhythms and Sinus Arrhythmias 1.ECG of Sinus Rhythms Sinus rhythm must originate in the sino-atrial node. 1).Regularly recurring sequences of P waves, QRS complexes,and T waves.P-P or R-R interval establishes a specific interval which should not vary more than 0.12 second

I.Sinus Rhythms and Sinus Arrhythmias ◼ 1.ECG of Sinus Rhythms Sinus rhythm must originate in the sino-atrial node. 1).Regularly recurring sequences of P waves, QRS complexes,and T waves.P-P or R-R interval establishes a specific interval which should not vary more than 0.12 second

I.Sinus Rhythms and Sinus Arrhythmias 2).The P wave is upward in lead I,II,avFV4-5 and downward in lead avR. 3).The PR interval>0.12 second. 4).Heart rate between 60 and 100 rates per minute

I.Sinus Rhythms and Sinus Arrhythmias ◼ 2).The P wave is upward in lead I,II, avF,V4-5 and downward in lead avR. 3).The PR interval>0.12 second. 4).Heart rate between 60 and 100 rates per minute

aVR 图3-3正常心电图

I.Sinus Rhythms and Sinus Arrhythmias ■2.Sinus Tachycardia 1).1).2).and3) 2).Heart rate exceeding 100 per minute

I.Sinus Rhythms and Sinus Arrhythmias ◼ 2. Sinus Tachycardia 1). 1).2).and 3) 2).Heart rate exceeding 100 per minute

Factors associated with Sinus Tachycardia: Physiologic Exercise Strong emotion Pain Anxiety states

◼ Factors associated with Sinus Tachycardia: Physiologic Exercise Strong emotion Pain Anxiety states

I.Sinus Rhythms and Sinus Arrhythmias Pathologic Fever Hyperthyroidism Hemorrhage Shock Anemia Infection Congestive heart failure Myocarditis Hypoxia

◼ Pathologic Fever Hyperthyroidism Hemorrhage Shock Anemia Infection Congestive heart failure Myocarditis Hypoxia I.Sinus Rhythms and Sinus Arrhythmias

I.Sinus Rhythms and Sinus Arrhythmias Other factors Drugs Epinephrine Atropine Food,etc Tea coffee Alcohol Tobacco

◼ Other factors Drugs Epinephrine Atropine Food,etc Tea coffee Alcohol Tobacco I.Sinus Rhythms and Sinus Arrhythmias

I.Sinus Rhythms and Sinus Arrhythmias ■3.Sinus Bradycardia 1).1),2)and3). 2).Heart rate is less than 60 per minute

◼ 3.Sinus Bradycardia 1).1),2) and 3). 2).Heart rate is less than 60 per minute. I.Sinus Rhythms and Sinus Arrhythmias

图10-3窦性心动过缓合并窦性心律不齐

I.Sinus Rhythms and Sinus Arrhythmias Common causes Physiologic bradycardia Laborers and trained athletes Emotional states leading to syncope Carotid sinus pressure,eyeball pressure,intracranial pressure Sleep

◼ Common causes ◼ Physiologic bradycardia Laborers and trained athletes Emotional states leading to syncope Carotid sinus pressure, eyeball pressure,intracranial pressure Sleep I. Sinus Rhythms and Sinus Arrhythmias