{"id":112,"date":"2019-05-28T14:00:00","date_gmt":"2019-05-28T12:00:00","guid":{"rendered":"https:\/\/admsu.org\/w\/?p=112"},"modified":"2019-05-31T16:01:27","modified_gmt":"2019-05-31T14:01:27","slug":"ecg-n2-reponse","status":"publish","type":"post","link":"https:\/\/admsu.org\/w\/ecg-n2-reponse\/","title":{"rendered":"ECG n\u00b02 &#8211; R\u00e9ponse"},"content":{"rendered":"\n<figure class=\"wp-block-image\"><a href=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-1.png\"><img loading=\"lazy\" decoding=\"async\" width=\"969\" height=\"1024\" src=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-1-969x1024.png\" alt=\"\" class=\"wp-image-113\" srcset=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-1-969x1024.png 969w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-1-284x300.png 284w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-1-768x812.png 768w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-1.png 1546w\" sizes=\"auto, (max-width: 767px) 89vw, (max-width: 1000px) 54vw, (max-width: 1071px) 543px, 580px\" \/><\/a><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Interpr\u00e9tation <\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>R\u00e9glages : d\u00e9filement \u00e0 25mm\/s (normal), calibration non renseign\u00e9e.<\/li><li>Rythme sinusal et r\u00e9gulier, PR &lt; 200ms<\/li><li>QRS fins, axe de d\u00e9polarisation ~85\u00b0<\/li><li>Segment ST sus d\u00e9cal\u00e9 en territoire inf\u00e9rieur avec un point J sur\u00e9lev\u00e9 \u00e0 plus de 1mm en DII, DIII et aVF, ainsi qu&#8217;en V4R. Miroir en V2 et DI, aVL (lat\u00e9ral haut)<\/li><li>Pas d&#8217;onde Q<\/li><\/ul>\n\n\n\n<p>Au total : infarctus du myocarde avec \u00e9l\u00e9vation du segment ST (STEMI) en territoire inf\u00e9rieur et droit \u00e9vocateur d&#8217;une atteinte de la coronaire droite. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pr\u00e9sentation<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Modification ECG en rapport avec un infarctus du myocarde<\/h3>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/Sans-titre.png\"><img loading=\"lazy\" decoding=\"async\" width=\"608\" height=\"424\" src=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/Sans-titre.png\" alt=\"\" class=\"wp-image-114\" srcset=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/Sans-titre.png 608w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/Sans-titre-300x209.png 300w\" sizes=\"auto, (max-width: 608px) 100vw, 608px\" \/><\/a><figcaption>Thygesen, Kristian, Joseph S. Alpert, Allan S. Jaffe, Maarten L. Simoons, Bernard R. Chaitman, Harvey D. White, the Writing Group on behalf of the Joint ESC\/ACCF\/AHA\/WHF Task Force for the Universal Definition of Myocardial Infarction, et al. \u00ab&nbsp;Third Universal Definition of Myocardial Infarction&nbsp;\u00bb. <em>European Heart Journal<\/em> 33, n<sup>o<\/sup> 20 (1 octobre 2012): 2551\u201167. <a href=\"https:\/\/doi.org\/10.1093\/eurheartj\/ehs184\">https:\/\/doi.org\/10.1093\/eurheartj\/ehs184<\/a>.<br>    <\/figcaption><\/figure>\n\n\n\n<h3 class=\"wp-block-heading\">Territoire \u00e9lectrique ECG et atteinte coronaire<\/h3>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/Sans-titre-1.png\"><img loading=\"lazy\" decoding=\"async\" width=\"796\" height=\"561\" src=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/Sans-titre-1.png\" alt=\"\" class=\"wp-image-115\" srcset=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/Sans-titre-1.png 796w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/Sans-titre-1-300x211.png 300w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/Sans-titre-1-768x541.png 768w\" sizes=\"auto, (max-width: 767px) 89vw, (max-width: 1000px) 54vw, (max-width: 1071px) 543px, 580px\" \/><\/a><figcaption>http:\/\/www.e-cardiogram.com\/ecg-lexique_alpha.php?terme_lex=t&amp;id_lex=438<\/figcaption><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Corr\u00e9lation ECG et atteinte Ventricule droit<\/h2>\n\n\n\n<p>Il faut toujours rechercher une atteinte du ventricule droit en cas d&#8217;infarctus inf\u00e9rieur. Dans la litt\u00e9rature, jusqu&#8217;\u00e0 40% des infarctus inf\u00e9rieurs sont compliqu\u00e9s d&#8217;une atteinte VD. En revanche l&#8217;atteinte isol\u00e9e du VD est extr\u00eamement rare.<\/p>\n\n\n\n<p>Cela peut impacter la prise en charge. En effet le ventricule droit \u00e9tant pr\u00e9charge d\u00e9pendant, en cas de d\u00e9faut de contractilit\u00e9, l&#8217;administration de d\u00e9riv\u00e9s nitr\u00e9s peut pr\u00e9cipiter un \u00e9tat de choc cardiog\u00e9nique.<\/p>\n\n\n\n<p>Il est possible de trouver, sur un ECG 12 d\u00e9rivations, des signes d&#8217;atteinte du ventricule droit :<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Sus ST en V1<\/li><li>Sus ST en DIII &gt; sus ST en DII<\/li><li>Sus ST en V1 &gt; Sus ST en V2<\/li><li>Sus ST en V1 et sous ST en V2<\/li><\/ul>\n\n\n\n<p>Pour confirmer cette hypoth\u00e8se, il faudra r\u00e9aliser un ECG 18 d\u00e9rivations qui devra montrer un sus ST en V3R, V4R.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Bibliographie<\/h3>\n\n\n\n<figure class=\"wp-block-embed-wordpress wp-block-embed is-type-wp-embed is-provider-life-in-the-fast-lane-litfl-medical-blog\"><div class=\"wp-block-embed__wrapper\">\nhttps:\/\/litfl.com\/right-ventricular-infarction-ecg-library\/\n<\/div><\/figure>\n\n\n\n<p><a href=\"https:\/\/www.e-cardiogram.com\/\">https:\/\/www.e-cardiogram.com\/<\/a><\/p>\n\n\n\n<p>Sanaani, Abdallah, Srikanth Yandrapalli, George Jolly, Rajiv Paudel, Howard A. Cooper, et Wilbert S. Aronow. \u00ab&nbsp;Correlation between electrocardiographic changes and coronary findings in patients with acute myocardial infarction and single-vessel disease&nbsp;\u00bb. Annals of Translational Medicine 5, no 17 (septembre 2017): 347\u2011347. https:\/\/doi.org\/10.21037\/atm.2017.06.33.<\/p>\n\n\n\n<p>Kanovsky, Jan, Petr Kala, Tomas Novotny, Klara Benesova, Maria Holicka, Jiri Jarkovsky, Lumir Koc, Monika Mikolaskova, Tomas Ondrus, et Marek Malik. \u00ab&nbsp;Association of the Right Ventricle Impairment with Electrocardiographic Localization and Related Artery in Patients with ST-Elevation Myocardial Infarction&nbsp;\u00bb. Journal of Electrocardiology 49, no 6 (novembre 2016): 907\u201110. https:\/\/doi.org\/10.1016\/j.jelectrocard.2016.08.001.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Interpr\u00e9tation R\u00e9glages : d\u00e9filement \u00e0 25mm\/s (normal), calibration non renseign\u00e9e. Rythme sinusal et r\u00e9gulier, PR &lt; 200ms QRS fins, axe de d\u00e9polarisation ~85\u00b0 Segment ST sus d\u00e9cal\u00e9 en territoire inf\u00e9rieur avec un point J sur\u00e9lev\u00e9 \u00e0 plus de 1mm en DII, DIII et aVF, ainsi qu&#8217;en V4R. Miroir en V2 et DI, aVL (lat\u00e9ral haut) &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/admsu.org\/w\/ecg-n2-reponse\/\" class=\"more-link\">Continuer la lecture<span class=\"screen-reader-text\"> de &laquo;&nbsp;ECG n\u00b02 &#8211; R\u00e9ponse&nbsp;&raquo;<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[5],"tags":[4,6,8,7,9],"class_list":["post-112","post","type-post","status-publish","format-standard","hentry","category-ecg-commente","tag-ecg","tag-infarctus","tag-infarctus-inferieur","tag-stemi","tag-territoire-electrique"],"_links":{"self":[{"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/posts\/112","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/comments?post=112"}],"version-history":[{"count":8,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/posts\/112\/revisions"}],"predecessor-version":[{"id":182,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/posts\/112\/revisions\/182"}],"wp:attachment":[{"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/media?parent=112"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/categories?post=112"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/tags?post=112"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}