Kelainan Ekg 2
Transcript of Kelainan Ekg 2
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KELAINAN DALAM EKG
• Kelainan yg bisa dinilai dari EKG
a. Pembesaran ruang jantung
b.Aritmia
c.Gangguan konduksi
d.Penyakit Jantung Koroner
e.Pre-exitasi
f. Lain-lain (Ggn.Elektrolit, Pericarditis, Intoxicasi obat)
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Kelainan Jantung
1. Pacemaker aritmia
2. Gangguan Konduksi1) AV Node
2) His : RBBB ; LBBB (LAHB,LPHB)
3) Pre eksitasi (WPW;LGL
3. Otot1) Atrium Hipertropi
2) Ventrikel Hipertropi ; iskemik / infark
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A. PEMBESARAN RUANG JANTUNG
• ATRIUM Keywords : gel P di Lead II.Lihat gel. P di Lead II. Normalnya < 0,10 s.Pada LAH : P melebar dan bertakik (broad & notch).
Disebut juga dgn P MITRALPada RAH : P meruncing. Disebut juga dgn P
PULMONAL
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HIPERTROPI ATRIUM KANAN (RAH)
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HIPERTROFI ATRIUM KIRI (LAH)
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• VENTRIKELKeywords : gel R di V1,V5 atau V6 dan gel S
di V1.RVH: lihat di V1. gambaran Rs (gel r lbh
besar daripada gel s)LVH : lihat gel R di V5 atau V6, bila ≥ 27
kotakkecil. Bila < 27, lihat gel S di V1. bila R di V5/V6 + S di V1 ≥ 35 maka LVH.
Bila R di V5 > V4 ada kmngkinan LVH, dan sebaliknya.
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HIPERTROFI VENTRIKEL KIRI (LVH)
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Atrial Flutter
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Atrial Fibrilasi (AF atau A Fib)
- AF SVR (slow ventrikel response) : < 60x/menit
- AF NVR (normo ventrikel response) : 60-100x/menit
- AF RVR (rapid ventrikel response) : > 100x/menit
- Irama IRREGULER
- Ada 2 bentuk: bentuk Halus (pd PJK,Cardiomiopathy) dan Kasar (RHD)
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Atrial Fibrilasi
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• Ventrikuler Ventrikel Extra Sistole (VES)⁻ Bila selang-seling dgn sinus : VES Bigemini⁻ Bila 2 sinus 1 VES : VES Trigemini⁻ Bila 2 VES berurutan : VES Couplet ⁻ Bila ≥ 3 VES : VES Salvo atau Run Of VT
⁻ Bila terdapat 2 fokus VES dalam 1 lead : Multi focal VES⁻ VES R on T (malignan), sering dijumpai pada MI. Ventrikel Takikardi : frekuensi > 100x/menit Ventrikel Fibrilasi : merupakan VT tanpa nadi
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C. Gangguan Konduksi • AV Block (di semua lead) Derajat 1 (PR > 0,22) Derajat 2 : oMobitz type 1: PR memanjang bertahap dan diakhiri 1
drop beat oMobitz type 2 : PR konstan dan terdapat 2 drop beats Derajat 3 (total AV Block) : tidak ada hubungan antara P
dan QRS (escape beats)
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Derajat 2
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• RBBB (right bundle branch block)– Lihat di V1. terdapat gambaran rSR’– RBBB complete : rSR’ ≥0,12 dan T inverted– RBBB incomplete : rSR’ ≤ 0,012 dan T upright• LBBB (left bundle branch block)– lihat di V5 atau V6. gambaran RsR’. Complete (T
inverted), Incomplete (T upright)– LAHB : QRS muatan (-) di Lead I ( posisi Horizontal,axis
-40°)– LPHB : QRS muatan (-) di lead II (posisi Vertical,axis
100°)
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RBBB
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LBBB
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