201441872 Infarct Miocardic Acut
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INFARCTUL MIOCARDIC ACUTINFARCTUL MIOCARDIC ACUT
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DEFINIŢIEDEFINIŢIE
Infarctul miocardic este consecinţa unei ocluzii a unei artere coronare.
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ISCHEMIA:
cauza: ocluzia parţială a coronarelor, cudiminuarea iriaţiei !anuine
EKG: modificări a undei T unda T negativă (inversată) LEZIUNE :
cauza: ocluzia "o"ală a coronarelor # $n!eamnă in%arc" recen" &acu"'
Nu !e decelează necroza miocardului
EKG: supradenivelare segment ST
subdenivelare segment ST NECROZ: Impune diano!"icul de in%arc"
Apare necroza miocardică
EKG –prezenţa undei
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(u)endocardic
Tran!mural
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I!c*emie: unda T negativă (inversată)Leziune: Subdenivelare ST
!"G#"$ %E&T'!$
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Modificări ECGModificări ECG
Q pathologic
Unda T
amplu turtit inverat
!T upradenivelare
!T u"denivelare
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IM#IM#
C$ITE$II DE DI#GN%!TICC$ITE$II DE DI#GN%!TIC
Unda T Unda T nea"i+ă
SEGMENT ST:SEGMENT ST:
(upradeni+elare (T
(u)deni+elare (T & IM !u)endocardic '
UNDA QUNDA Q::
Adncă c" - pă"ra"e
Lară c" un mic pă"ra" &,/!' A0une la 123 din dimen!iunea
comple4ului 5R(
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UND# QUND# Q
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QQ &'#T%(%GIC&'#T%(%GIC
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Impor"an"6
(ă %ie prezen"ă in cel puţin- deri+aţii con!ecu"i+e
!U'$#DENI)E(#$E !T!U'$#DENI)E(#$E !T
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Evolu*ia infarctului miocardicEvolu*ia infarctului miocardic
(a + minut după IM
unda T acu*ită
'ete + oră
!upradenivelare !T
'ete , ore
Formarea undei Q
'ete ,- ore Modificări tardive
Q patologic. T negativ
'ete o lună
Q
R
P
QT
STR
P
Q
ST
P
Q
T
ST
R
P
S
T
P
Q
T
ST
R
P
Q
T
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!upradenivelare !T!upradenivelare !T
fa/a hiperacutăfa/a hiperacută
R
P
Q
ST
7e!"e 1 oră
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Q patologicQ patologic
R
P
Q
T
ST
7e!"e 8 ore
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Unda T negativăUnda T negativă
R
P
QT
ST
7e!"e -/ ore
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INF#$CT MINF#$CT MII%C#$DI%C#$DIC #CUTC #CUT00 M%DIFIC1$IM%DIFIC1$I ECGECG
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(%C#(I2#$E# INF#$CTU(UI(%C#(I2#$E# INF#$CTU(UI
MI%C#$DICMI%C#$DIC
Inferior
II, III, aVF
Lateral
I, AVL,V5-V6
Anterior /
Septal
V1-V4
Posterior
V1-V3
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INF#$CTINF#$CT #NTE$I%$ #NTE$I%$
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I II III aVR aVL aVF V1 V2 V3 V4 V5 V6
Artera oronar! st"n#!
An"erior
91,9-, 93,9/
INF#$CTINF#$CT #NTE$I%$ #NTE$I%$
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INF#$CT (#TE$#(INF#$CT (#TE$#(
I II III aVR aVL aVF V1 V2 V3 V4 V5 V6
Artera oronar! st"n#!,
ra$%ra ir%$fle&!
La"eral
I, A9L,9, 98
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INF#$CT #NTE$%&(#TE$#(INF#$CT #NTE$%&(#TE$#(
An"erior 9-, 9/
La"eral I, A9L, 9, 98
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INF#$CT INFE$I%$INF#$CT INFE$I%$
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I II III aVR aVL aVF V1 V2 V3 V4 V5 V6
Artera oronar! 'reapt!
In%erior
II, III, A9F
INF#$CT INFE$I%$INF#$CT INFE$I%$
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For more pre!en"a"ion!;;;.medicalpp".)lo!po".com
INF#$CT INFE$I%$INF#$CT INFE$I%$In%erior
II, III, A9F
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INF#$CT '%!TE$I%$INF#$CT '%!TE$I%$
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INF#$CT MI%C#$DIC N%N & QINF#$CT MI%C#$DIC N%N & Q
In%arc" !u)endocardic
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INF#$CT MI%C#$DICINF#$CT MI%C#$DIC
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INF#$CT MI%C#$DICINF#$CT MI%C#$DIC
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INF#$CT MI%C#$DICINF#$CT MI%C#$DIC