ดาวน์โหลดงานนำเสนอ
งานนำเสนอกำลังจะดาวน์โหลด โปรดรอ
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III III
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ทำไมเราต้องเรียน “Pediatric ECG”? Arrhythmia diagnosis and management Provides clues for the diagnosis of CHD Indicative of other associated problems May identify some discrepancies of the diagnosis prompting further testing or a more careful review of the existing data
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Characteristics for evaluating of ECG
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Normal ECG
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0.04 seconds
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0.20 seconds
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Standardize
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q-wave R-wave
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R-R interval p-p interval
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0-7 days1wk – 1m1 m-6m6m-1yr1yr-5yr5-10yr10-15yr>15yr Heart rate90-160100-175 110-180100-180 70-16065-14060-13060-100 P-R interval 0.08-0.15 0.09-0.180.10-0.20 QRS duration0.03-0.07 0.04-0.08 0.04-0.090.06-0.09 QRS axis 70-180 45-16010-120 5-110 QRS V1 Q 0 R5-253-22 3-202-20 2-181-151-121-6 S0-220-160-151-20 3-212-223-13 QRS V5 Q0-10-3 0-5 0-30-2 R2-203-255-3010-30 10-3513-3810-35 7-21 S2-192-161-161-141-131-111-100-5 QRS V6 Q0-20-30-40-30-2 R1-121-173-205-226-22 8-25 8-245-18 S0-90-70-60-40-2 Maximum QTc0.450.440.43 T wave V1**-3 to +4 -6 to -1 -6 to +2-4 to +3-2 to +2
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0-7 days1wk – 1m1 m-6m6m-1yr1yr-5yr5-10yr10-15yr>15yr Heart rate90-160100-175 110-180100-180 70-16065-14060-13060-100 P-R interval 0.08-0.15 0.09-0.180.10-0.20 QRS duration0.03-0.07 0.04-0.08 0.04-0.090.06-0.09 QRS axis70-18045-16010-1205-110 QRS V1 Q 0 R5-253-22 3-202-20 2-181-151-121-6 S0-220-160-151-20 3-212-223-13 QRS V5 Q0-10-3 0-5 0-30-2 R2-203-255-3010-30 10-3513-3810-35 7-21 S2-192-161-161-141-131-111-100-5 QRS V6 Q0-20-30-40-30-2 R1-121-173-205-226-22 8-25 8-245-18 S0-90-70-60-40-2 Maximum QTc0.450.440.43 T wave V1**-3 to +4-6 to -1-6 to +2-4 to +3-2 to +2
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0-7 days1wk – 1m1 m-6m6m-1yr1yr-5yr5-10yr10-15yr>15yr Heart rate90-160100-175 110-180100-180 70-16065-14060-13060-100 P-R interval 0.08-0.15 0.09-0.180.10-0.20 QRS duration0.03-0.07 0.04-0.08 0.04-0.090.06-0.09 QRS axis70-18045-16010-1205-110 QRS V1 Q 0 R5-253-22 3-202-20 2-181-151-121-6 S0-220-160-151-20 3-212-223-13 QRS V5 Q0-10-3 0-5 0-30-2 R2-203-255-3010-30 10-3513-3810-35 7-21 S2-192-161-161-141-131-111-100-5 QRS V6 Q0-20-30-40-30-2 R1-121-173-205-226-22 8-25 8-245-18 S0-90-70-60-40-2 Maximum QTc0.450.440.43 T wave V1**-3 to +4-6 to -1-6 to +2-4 to +3-2 to +2
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0-7 days1wk – 1m1 m-6m6m-1yr1yr-5yr5-10yr10-15yr>15yr Heart rate90-160100-175 110-180100-180 70-16065-14060-13060-100 P-R interval 0.08-0.15 0.09-0.180.10-0.20 QRS duration0.03-0.07 0.04-0.08 0.04-0.090.06-0.09 QRS axis70-18045-16010-1205-110 QRS V1 Q 0 R5-253-22 3-202-20 2-181-151-121-6 S0-220-160-151-20 3-212-223-13 QRS V5 Q0-10-3 0-5 0-30-2 R2-203-255-3010-30 10-3513-3810-35 7-21 S2-192-161-161-141-131-111-100-5 QRS V6 Q0-20-30-40-30-2 R1-121-173-205-226-22 8-25 8-245-18 S0-90-70-60-40-2 Maximum QTc0.450.440.43 T wave V1**-3 to +4-6 to -1-6 to +2-4 to +3-2 to +2
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0-7 days1wk – 1m1 m-6m6m-1yr1yr-5yr5-10yr10-15yr>15yr Heart rate90-160100-175 110-180100-180 70-16065-14060-13060-100 P-R interval 0.08-0.15 0.09-0.180.10-0.20 QRS duration0.03-0.07 0.04-0.08 0.04-0.090.06-0.09 QRS axis70-18045-16010-1205-110 QRS V1 Q 0 R5-253-22 3-202-20 2-181-151-121-6 S0-220-160-151-20 3-212-223-13 QRS V5 Q0-10-3 0-5 0-30-2 R2-203-255-3010-30 10-3513-3810-35 7-21 S2-192-161-161-141-131-111-100-5 QRS V6 Q0-20-30-40-30-2 R1-121-173-205-226-22 8-25 8-245-18 S0-90-70-60-40-2 Maximum QTc0.450.440.43 T wave V1**-3 to +4-6 to -1-6 to +2-4 to +3-2 to +2
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0-7 days1wk – 1m1 m-6m6m-1yr1yr-5yr5-10yr10-15yr>15yr Heart rate90-160100-175 110-180100-180 70-16065-14060-13060-100 P-R interval 0.08-0.15 0.09-0.180.10-0.20 QRS duration0.03-0.07 0.04-0.08 0.04-0.090.06-0.09 QRS axis70-18045-16010-1205-110 QRS V1 Q 0 R5-253-22 3-202-20 2-181-151-121-6 S0-220-160-151-20 3-212-223-13 QRS V5 Q0-10-3 0-5 0-30-2 R2-203-255-3010-30 10-3513-3810-35 7-21 S2-192-161-161-141-131-111-100-5 QRS V6 Q0-20-30-40-30-2 R1-121-173-205-226-22 8-25 8-245-18 S0-90-70-60-40-2 Maximum QTc0.450.440.43 T wave V1** -3 to +4 -6 to -1 -6 to +2-4 to +3-2 to +2
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I V1V1
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Right Ventricular Hypertrophy (RVH) R-wave in the right chest leads > 98 percentile for age S-wave in the left chest leads > 98 percentile for age Abnormal R/S ratio in the right chest leads qR pattern in the right chest leads rsR or rR pattern in the right chest leads Abnormal t-wave direction in the right chest leads Right axis deviation
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Left Ventricular Hypertrophy (LVH) R-wave in the left chest leads > 98 percentile for age S-wave in the right chest leads > 98 percentile for age Abnormal R/S ratio in the left chest leads Deep Q in the left chest leads Abnormal t-wave direction in the left chest leads Left axis deviation
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Combined Ventricular Hypertrophy (CVH) Signs of LVH + RVH R+S-wave amplitude in V2 to V5 > 60 mm
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Quiz 1 ให้อ่าน ECG นี้
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Quiz 2 ทารกอายุ 1 วัน ฟังได้ systolic murmur เบาๆ ตรวจไม่พบความผิดปกติอื่นใด
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Quiz 3 เด็กอายุ 1 เดือน เหนื่อยหอบ เลี้ยงไม่โต หัวใจมี hyperactive precordium ฟังได้ systolic murmur ตับโต
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Quiz 4 เด็กอายุ 5 ปี พัฒนาการช้า มีปอดอักเสบมานอนโรงพยาบาล ลักษณะเป็น Mongoloid face, hypotonia Chest x-ray พบว่าหัวใจโต
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Quiz 5 เด็กอายุ 7 ปี ใจสั่นมา 1 ชั่วโมงก่อน ตอนมาหายแล้ว ตรวจร่างกายไม่พบความผิดปกติใดๆ
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