醫學筆記匯整 ED Notes

• 下壁梗塞佔了所有 MI 的40-50%
• 40% 下壁梗塞合併 RV infarction 
• 20% 下壁梗塞合併 bradycardia due to 2 or 3 degree AV block
• STE or Q over leads II, III and aVF
  Reciprocal STD in aVL (± lead I) ( 下外下, 前下 )

Irregular wide QRS tachycardia 三個鑑別診斷

1.  Af + WPW 
   

AVRT (Atrio-ventricular reciprocal) : 1/3
有 accessory apathway, WPW

- Orthodromic : 90%, 走 AV node 當然 narrow QRS
                           會 short RP

 - Antidromic : 10%, 走 accessory apathway 所以 wide QRS !!
                          屬於 regular wide QRS tachycardia
                          會 long RP

1. Ulcerations of mouth and lips
2. Bilateral lung infiltrates / Desaturation 肺
3. Acute kidney injury / Renal failure 腎
4. Jaundice / Liver failure 肝

 Polymorphic ventricular tachycardia ( PVT ) 
- A form of VT

(1) 維生素B1 (thiamine)：wernicke's encephalopathy
(2) 葡萄糖 (glucose)：低血糖

 * 處置 > 診斷