Bài giảng điện tâm đồ nhồi máu cơ tim

BS Traàn Kim Trang

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,-./!%)0)
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3'#%&(!*8!') 99≥
:Kinh ñieån
;1 <<.8=>0!0!)+?!!#!≥
+!@A
;1! BC)*+0)4D! ≥
:Theo ACC/ESC=7<<<A
;E!%#F4*8+1!*#*G
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%G
H
;1 <<H8I@JJ!GJ!GKJG≥
.
JG
L
JG
M

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=,-()*+0@F0'+)@#0!4D0I+
(#$F0@ )@!1C9!*0O+!@92'
CA
0 #$I+ 

 -')0)!D2034
 C <799≤
 -')0)!D204
G
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>0'+
 >0'+ G
7
C <<80!" 99≤ ≤
 >0'+ G
H
C <<780!" 799≤ ≤
!GC >0'+ G
.
C P990!" 1≤ ≤
!G
C 1=2'A≤
G
L
C P990!" 71≤ ≤
!GK
C 71=2'A≤
G
M
C M990!" H1≤ ≤

II.1.3. Ñoaïn ST cheânh leân daïng voøm:
:! -#! 
D9Q 99≥
#*G


:G
H
(!* ≥
79950?+
F0!
-
! -&0!@
I@6#0!%#7
3'#%&0!)
.+-!@J!'0 


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C!
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•
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II.3. ,-F0'+8+12034
II.3.1. T!%)0)U!V#) #CW
H7X0!@0-,-T,3!#@!

.,-#0!*08!)
•
G

C <<.8JC M99JC ≥ ≥ ≥
•

G
7
C <<L8JC L99JC L≥ ≥ ≥

L>023F0!0=-A
- 15 7JJG≥
L:M
YF0!%5 7G≥
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=/!%)!2$$!A
:C+!@92'5G
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:-0'0Z)!!+8(I23F0!0=-A#0!4D
+0 
:)!%#01#$+0!#2&+! #!'9#0)
:-[-+)4'&0!#5 73\≥ nhau

II.6. >023F0!0=]A:
^#+!'43!\93!_

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/#$) 
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\+0\!*,-%)
•

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•
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R!4=]A
•

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–
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('9I#9J#!d+>!39!)
–
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#0!0!/! +2#

Beọnh cụ tim phỡ ủaùi coự hỡnh aỷnh gioỏng NMCT

Vieâm cô tim do AIDS hình aûnh gioáng NMCT

712034*+!"&#$+I
#0!%#
I#0!%##$!=&$Ce!(&$+$88A
I#0!%#&0!@=!"2##$+]TA

C%3! /!_#$)4\E3F0!0=-AJf]f
12/1/93: WPW với (-) -> giống NMCT thành dưới∆
5/31/94: dẫn truyền bình thường
6/2/94: tái phát WPW -> giống NMCT thành dưới

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E0,G
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G'99!*++!*#9!%&,-
-0'0(*90X0!@08+I+
Z)!!0)4D! R)4'#!'9%

H-0'03'52034F0!
•
T!*4#0!%#=-A5E3F0!0=-A=G

:G
H
A
•
-0!4D2X0#0I*+/#! 8I9
•
+)4'0!'0%9+!"&
–
G'9I#9
–
0!%#0I+#9
–
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–
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–
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7
A
–
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.-!@+!"&#$+
:-0!4D2X0#0I*+
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:+-!@3!#!@# &0!#
:+-#0!4D#0&0!#23F0!0Jf]f
:-!/) +T+#!3
:G'99!*++!*#9
:C%3! +!@h

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G!0 G
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E'
 TI !GK TI G
H
-$I G
M

E'
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7C
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MC
J !" 2# G
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 ,- #0!%#=]AJ F*9
,-()*+/I

G
P
 % G
j
 ,- 8!) #0 J F*9 ,- ()*+
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8!)#0 

IV.1. Thaønh
tröôùc:

NMCT cấp xuyên thành trước vách, biến
chứng blốc nhánh (P)

IV.2. Thaønh beân:

IV.3. Thaønh döôùi:

IV.4. Thành sau(thực):
NMCT cấp trong
thành sau thực
NMCT cũ thành sau có
huyết khối & NMCTcấp
trước vách
Thủng vách liên thất sau NMCT
cấp trước vách, kèm NMCT cũ
thành sau