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Samenvatting Spiekbrief cardio AFP3
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Spiekbrief cardio AFP3
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SPIEKBRIEF ECG –1. Bepaal de hartfrequentie
Berekening NL en snel 300-150-100-75-60-50
Bradycardie (aantal cycli/6sec)x10
2. Beschrijf het hartritme
- Sinusritme? NL = regelmatig gelijke intervallen/P-top voor elk QRS
>< onregelmatig ectopische complexen= - prematuur (atriaal, av-nodaal, ventriculair (PVC of
VES)) - escape
snelle of trage ritmestoornissen
- P-top? (origine stimulus: sinusknoop? Atrial? AV-nodaal?
PQ > 1 groot vierkant = geleidingsvertraging bij AV-Blok?
Spikes (regelm. elektr. Impuls) elektrische pacemaker?
- Ectopische activiteit?
Snelle freq: sinustachycardie? Paroxysmale tachycardie? Flutter? Fibrillatie?
Trage freq: sinusbradycardie? Geleidingsstoornissen? (SA-blok, sinusarrest, AV-blok,
BTB)
3. Bepaal de elektrische hartas
Beoordeel QRS in
I+ en aVF+ NORMALE AS
I+ en aVF- LINKER AS
I- en aVF+ RECHTER AS
I- en aVF- EXTREME RECHTER AS
4. Evalueer het QRS-complex, het ST-segment en de T-top
1. Voltage?
Linker ventrikelhypertrofie? (S in V1 +R in V5 > 35mm)
Rechter ventrikelhypertrofie? (R > S in V1 of R in V1 > 7mm)
2. Morfologie?
Linker BTB? (RR’ in V5 -V6) GEEN DIAGNOSE INFARCT!
Rechter BTB (bundeltakblok)? (RR’ in V1 en V2)
3.
T-top: spits? Negatief? ISCHEMIE
ANTERIOR (V1-V4)
LATERAAL (I, aVL)
INFERIOR (III, aVF)
ST-segment: daling? NSTEMI? (hartenzymen!)
ST-segment: stijging? (acute necrose) STEMI
ANTERIOR (V1-V4)
LATERAAL (I, aVL)
INFERIOR (III, aVF)
Q: significant pathologisch? 1mm breed of 1/3de van hoogte QRS OUD INFARCT
ANTERIOR (V1-V4)
LATERAAL (I, aVL)
INFERIOR (III, aVF)
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