{"id":130,"date":"2019-06-04T14:00:01","date_gmt":"2019-06-04T12:00:01","guid":{"rendered":"https:\/\/admsu.org\/w\/?p=130"},"modified":"2019-06-05T10:24:55","modified_gmt":"2019-06-05T08:24:55","slug":"ecg-n3-reponse","status":"publish","type":"post","link":"https:\/\/admsu.org\/w\/ecg-n3-reponse\/","title":{"rendered":"ECG n\u00b03 &#8211; R\u00e9ponse"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Interpr\u00e9tation<\/h2>\n\n\n\n<figure class=\"wp-block-image\"><a href=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-3.png\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"513\" src=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-3-1024x513.png\" alt=\"\" class=\"wp-image-137\" srcset=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-3-1024x513.png 1024w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-3-300x150.png 300w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-3-768x385.png 768w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/p-3.png 1038w\" sizes=\"auto, (max-width: 767px) 89vw, (max-width: 1000px) 54vw, (max-width: 1071px) 543px, 580px\" \/><\/a><\/figure>\n\n\n\n<ul class=\"wp-block-list\"><li>Pas de r\u00e9glages inscrit<\/li><li>Rythme sinusal et r\u00e9gulier avec espace PR constante &lt; 200ms. Segment PR discr\u00e8tement sous d\u00e9cal\u00e9 de mani\u00e8re diffuse (j&#8217;admet que cela ne saute pas aux yeux, <em>trait rouge repr\u00e9sentant la ligne de base<\/em>)<\/li><li>QRS fins, FC~100bpm<\/li><li>Segment ST sus d\u00e9cal\u00e9 de mani\u00e8re diffuse, concave en haut, except\u00e9 en DIII et V2. Miroir en aVR et V1.<\/li><li>Pas d&#8217;onde Q<\/li><li>QT normal<\/li><\/ul>\n\n\n\n<p>=&gt; Au total sus d\u00e9calage diffus du segment ST avec discret sous d\u00e9calage du segment PQ qui peut faire \u00e9voquer un diagnostic de p\u00e9ricardite.<\/p>\n\n\n\n<div class=\"wp-block-image\"><figure class=\"aligncenter is-resized\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/pictograms-aem-0058-general-warning-hazard-2.png\" alt=\"\" class=\"wp-image-136\" width=\"33\" height=\"33\" srcset=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/pictograms-aem-0058-general-warning-hazard-2.png 256w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/pictograms-aem-0058-general-warning-hazard-2-150x150.png 150w, https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/pictograms-aem-0058-general-warning-hazard-2-100x100.png 100w\" sizes=\"auto, (max-width: 33px) 100vw, 33px\" \/><\/figure><\/div>\n\n\n\n<p>Le diagnostic diff\u00e9rentiel \u00e0 \u00e9voquer syst\u00e9matiquement en cas de trac\u00e9 \u00e9vocateur de p\u00e9ricardite est le syndrome coronarien aigue ST+.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Pr\u00e9sentation<\/h2>\n\n\n\n<h3 class=\"wp-block-heading\">Modification ECG &amp; P\u00e9ricardite<\/h3>\n\n\n\n<p>Les modifications \u00e9lectrocardiographiques observ\u00e9es lors d&#8217;une p\u00e9ricardite sont li\u00e9es \u00e0 l&#8217;inflammation de l&#8217;\u00e9picarde provoquant un courant de l\u00e9sion.<\/p>\n\n\n\n<p>On ne les observe que dans 60% des p\u00e9ricardites et lorsqu&#8217;ils sont pr\u00e9sents ne sont que moyennement marqu\u00e9s. La morphologie \u00e9volue en fonction du temps et r\u00e9pond au <em>cycle de Holzman<\/em> :<\/p>\n\n\n\n<p>A la phase initiale :<\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>Sus d\u00e9calage du segment ST, ascendant et concave (changement le plus sensible)<ul><li>plut\u00f4t diffus<\/li><li>souvent maximum en DII et v4-v5<\/li><li>parfois DI et v6<\/li><li>minimum en V1-V2<\/li><\/ul><\/li><li>Pas de miroir, sauf en aVR o\u00f9 l&#8217;aspect consante est ST-, parfois en V1<\/li><li>Sous d\u00e9calage du segment PQ (Signe de Spodick)<ul><li>inconstant mais sp\u00e9cifique<\/li><li>plus marqu\u00e9 en DII<\/li><\/ul><\/li><li>Ondes T amples<ul><li>fr\u00e9quent<\/li><li>ST\/T &gt; 0.25 en V4-V6<\/li><\/ul><\/li><\/ol>\n\n\n\n<figure class=\"wp-block-image\"><img loading=\"lazy\" decoding=\"async\" width=\"440\" height=\"431\" src=\"https:\/\/admsu.org\/w\/wp-content\/uploads\/2019\/05\/image1.gif\" alt=\"\" class=\"wp-image-138\"\/><figcaption>http:\/\/www-sante.ujf-grenoble.fr\/<\/figcaption><\/figure>\n\n\n\n<p><\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Bibliographie<\/h3>\n\n\n\n<p>Adler Y, Charron P, Imazio M, Badano L, Bar\u00f3n-Esquivias G, Bogaert J, et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). European Heart Journal. 2015 Nov 7;36(42):2921\u201364. <\/p>\n\n\n\n<p>LeWinter MM. Acute Pericarditis. Solomon CG, editor. New England Journal of Medicine. 2014 Dec 18;371(25):2410\u20136.<\/p>\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\/pericarditis-ecg-library\/\n<\/div><\/figure>\n\n\n\n<p><a href=\"https:\/\/www.e-cardiogram.com\/ecg-lexique_alpha.php?terme_lex=p&amp;id_lex=321\">https:\/\/www.e-cardiogram.com\/ecg-lexique_alpha.php?terme_lex=p&amp;id_lex=321<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Interpr\u00e9tation Pas de r\u00e9glages inscrit Rythme sinusal et r\u00e9gulier avec espace PR constante &lt; 200ms. Segment PR discr\u00e8tement sous d\u00e9cal\u00e9 de mani\u00e8re diffuse (j&#8217;admet que cela ne saute pas aux yeux, trait rouge repr\u00e9sentant la ligne de base) QRS fins, FC~100bpm Segment ST sus d\u00e9cal\u00e9 de mani\u00e8re diffuse, concave en haut, except\u00e9 en DIII et &hellip; <\/p>\n<p class=\"link-more\"><a href=\"https:\/\/admsu.org\/w\/ecg-n3-reponse\/\" class=\"more-link\">Continuer la lecture<span class=\"screen-reader-text\"> de &laquo;&nbsp;ECG n\u00b03 &#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":[12,13],"class_list":["post-130","post","type-post","status-publish","format-standard","hentry","category-ecg-commente","tag-pericardite","tag-st"],"_links":{"self":[{"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/posts\/130","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=130"}],"version-history":[{"count":5,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/posts\/130\/revisions"}],"predecessor-version":[{"id":142,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/posts\/130\/revisions\/142"}],"wp:attachment":[{"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/media?parent=130"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/categories?post=130"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/admsu.org\/w\/wp-json\/wp\/v2\/tags?post=130"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}