| ECFMG | Educational Commission on Foreign Medical Graduates; Educational Council for Foreign Medical Graduates |
|---|---|
| ECFMS | Educational Council for Foreign Medical Students |
| ECFV | extracellular fluid volume |
| ECFVD | extracellular fluid volume depletion |
| ECG | Electro-Cardio-Graphy(-Gram); 심전도 = EKG 1. Conducting System Structures 1) SA Node(SAN; 동(방)결절); Pacemaker 1> RA 의 Posterior Wall or Superior Wall 2> 가늘고 긴 계란 모양 3> 방실결절(AVN)보다 크다. 2) Internodal Tracts(결절간 전도로) (P 74) 1> Anterior Internodal Tract; Bachmann's Bundle 2> Middle Internodal Tract(= Wenckebach's Bundle) 3> Posterior Internodal Tract(= Thorel's Pathway) 3) AV Node(AVN; 방실결절) 1> 전도 속도; 200 mm/sec = 0.2 m/sec 2> 0.1 sec Delay 3> 계란형 4> 동방결절 절반 이하의 크기 5> 심방 중격 우측에 위치 4) Atrioventricular Tract 5) AV Bundle(방실속)(= Bundle of His) 6) Bundle Branch 1> Right Bundle Branch 2> Left Bundle Branch i) Anterior Branch; Posterior Branch에 비해서 길고 가늘며 Left Ventricle의 전방, 상방으로 흥분을 전달 ii) Posterior Branch; 짧고 굵은 가지, Left Ventricle의 후, 하방으로 흥분을 전달 7) Purkinje Fiber; 전도 속도; 4,000 mm/sec = 4 m/sec @ 전도 속도 Atrium(심방근); 1,000 mm/sec = 1 m/sec Ventricle(심실근); 400 mm/sec = 0.4 m/sec 2. Blood Supply System Structures 1) Right Coronary Artery(RCA); - Right Cusp of Aortic Valve 1> SA node 2> AV node 3> Bundle of His 4> Posterior Wall of Left Ventricle 5> Right Ventricle 6> Posterior Division of Left Bundle Branch 2) Left Coronary Artery(LCA); - Left Cusp of Aortic Valve 1> Right Bundle Branch 2> Anterior Division of Left Bundle Branch 3> Anterior Descending Branch 4> 3. Components @ Segment(분절); Baseline(기선)부 @ Interval(간격); Wave(파) 까지 포함 1) P Wave; Atrial Hypertrophy 를 Check 1> Atrial Depolarization, Atrial Contraction 2> Lead II; The Tallest P Wave Lead III, AVL; The Smallest P Wave AVR; Inverted P Wave 3> Normal; Height ≤ 2.4 mm Duration ≤ 0.11 sec 2) PP Interval; P Wave ~ P Wave; 심방 박동수 3) F Wave; Flutter Wave 4) PR Interval; AV Block을 진단 1> P Wave 의 시작 ~ QRS Complex 의 시작 2> 심방 흥분에서부터 Purkinje Fiber에 흥분파가 도달할때까지의 시간 심방의 탈분극과 방실전도에 걸리는 시간 3> Normal; 0.12 - 0.20 sec 4> Abnormal < 0.12 sec; 심방전도촉진 > 0.20 sec; 1o AV Block 5) 심실흥분시간(VDT) 1> QRS Complex 개시 ~ R Wave 꼭지점까지 2> 탈분극파가 심장의 안쪽(심내막)에서 바깥쪽(심외막)까지 전달되는데 걸리는 시간 6) QRS Complex; Bundle Branch Block을 진단 ; Ventricular Depolarization, Ventricular Contraction ; Axis 결정 ; Normal; 0.04 - 0.11 sec 1> Q Wave; R Wave의 앞에 있는 음성파 ; Normal 로는 거의 없다(예외, AVR) i) Insignificant Q Wave; small Q Wave in I, II, V5,6 ii) Significant Q Wave Wide ≥ 1 mm(0.04 sec) or Height ≥ 1/3 of QRS Complex Myocardial Infarction 2> R Wave; 양성파 3> S Wave; R Wave에 잇달아 있는 음성파 4> Ta Wave i) Atrial Repolarization ii) P Wave 와는 반대 방향 iii) QRS Complex와 일치되어 거의 볼수 없다. 4> QS Wave 5> QR Wave 6> RS Wave 7> RSR'S' Wave 7) RR Interval; 심실박동수 8) QT Interval 1> QRS Complex 의 시작 ~ T Wave 끝까지 2> 심실의 탈분극과 재분극을 모두 포함하는 시간 9) J Point 10) ST Segment; QRS Complex의 끝 ~ T Wave의 시작점 @ ST Segment Depression 1> Digitalis Intoxication 2> Positive Master's Test; 관상동맥질환이 의심되는 환자가 운동하는 것 3> Anterior Wall Subendocardial Infarction 4> Unstable Angina 에 Pain이 있을 시; No Pain시는 ST Segment Normal 5> Acute Posterior Wall Infarction 11) T Wave; Ventricular Repolarization 12) U Wave 1> Ventricle 의 지연 Repolarization 2> T Wave 뒤에 3> T Wave 와 같은 방향 4> 보이는 경우; Hypokalemia, Quinidine 4. Leads 1) Limb Leads; Frontal Plane; Axis 결정 @ Standard Lead; Bipolar Lead 1> Lead I; RA(-) LA(+); Axis Deviation 2> Lead II; RA(-) LF(+) 3> Lead III; LA(-) LF(+) @ Augmented Lead; Unipolar Lead 4> AVR; RA(+) LA, LF, RF(-); Normal Inverted T Wave, Normal Large Q Wave; Lead II와 반대 5> AVL; LA(+) RA, LF, RF(-) 6> AVF; LF(+) RA, LA, RF(-); Axis Deviation 2) Chest Leads(= Precordial Lead); Horizontal Plane; Unipolar Lead * 우측 흉부 유도(Right Chest Leads); Right BBB Check; Right Ventricle 위에 1> V1; 4th Intercostal Space, Right Sternal Border; Hypertrophy 2> V2; 4th Intercostal Space, Left Sternal Border; AV Node 의 Front * 심실중격위에 위치(Septal Lead; 중격유도); Interventricular Septum위에 ; Transitional Zone(이행부위); QRS Complex 에서 R Wave와 S Wave의 높이가 같아지는 곳 3> V3; Between V2 & V4 4> V4; 5th Intercostal Space, Left Midcalvicular Line * 좌측 흉부 유도(Left Chest Leads); Left BBB; Left Ventricle위에 놓인다. 5> V5; 5th Intercostal Space, Anterior Axillary Line 6> V6; 5th Intercostal Space, Middle Axillary Line @ Einthoven's Triangle RA - LA - LF @ Einthoven's Law; QRS Complex의 상하 진폭의 합 Lead II = Lead I + Lead III 5. Rates; Normal; 80/min 1) Pacemakers 1> SA Node 2> Ectopic(= Potential) Pacemaker; Inherent Rates i) Atrial(= Idioatrial); 75/min ii) AV node(= Idionodal); 60/min; P Wave가 없다. iii) Ventricular(= Idioventricular); 30 - 40/min 2) Emergency Rates; 150 - 250/min 3) Sinus Tachycardia; > 100/min, Regular Rhythm 4) Sinus Bradycardia; < 60/min, Regular Rhythm 5) 300, 150, 100, 75, 60, 50 250, 136, 94, 71 214, 125, 88, 68 187, 115, 83, 65 167, 107, 79, 62 6) 3 Second Marks; x 20 6 Second Strips; x 10 6. Rhythm 1) Arrhythmia(Varying Rhythm) 1> Sinus Arrhythmia i) 관상동맥질환에 의해서 Coronary Artery Disease Sick Sinus node Disease ii) Pacemaker; SA node iii) Varying rhythm iv) P Waves Identical; 모든 P Wave는 동일 2> Wandering Pacemaker i) Varying rhythm ii) P Wave Shape Changes 2) Extra Beats & Skips 1> Premature Beats; 기외수축 = Premature Contractions(조기수축) = Extrasystoles = Ectopic Beats = Ectopic Contractions(이소성수축) ; Ectopic Pacemaker에서 발생되어 심방주기보다 조기에 일어나는 심장수축 i) Atrial Premature; Abnormal P Waves * 진단 기준 심장주기보다 빨리 일어난다. P Wave 가 동성 P Wave와는 다르다. Normal QRS Complex ii) Nodal Premature Contractions * 진단 기준 심장주기보다 빨리 일어난다. 정상 PR Interval보다 짧은 PR Interval을 가진 P Wave가 QRS Complex앞에 온다. or Inverted P Wave Normal QRS Complex --SAN --AVN iii) Ventricular Premature(= Paroxysmal Ventricular Contractions(PVC)) Wide QRS Complex Large QRS Complex following Compensatory Pause 1 or 2 이상의 normal Beats와 coupled e.g) Bigeminy, Trigeminy, Quadrigeminy 등등 [P 94] 대개 정상 T Wave 다음에 생긴다. T Wave와 겹친다면 굉장히 불안정한 순간이며 위험한 부정맥이 유발될수도 있다. * 진단 기준 심장주기보다 빨리 일어난다. No Ectopic P Wave Wide(≥ 0.12 sec) QRS Complex iv) Parasystole 2> Escape Beats(보충수축); Ectopic Pacemaker에서 발생되어 심방주기보다 늦게 나타나는 수축 i) Atrial Escape; P Wave 모양이 다르다. ii) AV nodal(= Junctional, Idionodal) Escape ; 6개 이상의 연속되는 40 - 60/min * 원인 동성 자극이 일어나지 않거나 자극 전도 차단이 있어서 동성 자극이 전달되지 않는 경우 * 진단 기준 정상심장주기보다 늦게 나타난다. 정상 QRS Complex No P Wave Response or Inverted P Wave가 QRS Complex에 앞서거나 뒤서거나 또는 그렇지 않거나 동성 P Wave가 선행하는 경우 PR Interval이 짧아진다. * Accelerated Idioventricular Rhythm ; 6개 이상 연속으로 일어나는 40 - 100/min의 심실성기외수축 iii) Ventricular Escape Rhythm ; 6개 이상의 연속되는 ≤ 40/min의 심실성보충수축 PVC type Ventricular Response * 진단 기준 정상심장주기보다 늦게 나타난다. No Ectopic P Wave Wide QRS Complex ≤ 40/min iv) Escape Rhythm; 3> Sinus Arrest 4> Sinus Exit Block i) Bradycardia ii) No P Waves iii) Tx; Permanent Artificial Pacemaker 3) Rapid Rhythm 1> (Paroxysmal) Tachycardia; 150 - 250/min i) Sinus Tachycardia 원인; 흥분, 운동, 자극제(Stimulating Drug), Shock ii) (Paroxysmal) Atrial Tachycardia(= PAT); 6개 이상의 APCs가 140 - 220/min로 일어나는 경우 * 진단 기준 최초의 자극은 조기에 일어난다. 이소성 P Wave는 동성 P Wave와 다르다. Normal QRS Complex Regular PR Interval Ventricular rate; 140 - 220/min @ (Paroxysmal) Atrial Tachycardia with Block; Atrial Tachycardia가 ≤ 180/min가 되면 심방흥분이 모두 AVN과 Ventricle에 전달되나 그 이상이 되는 경우 선행하는 흥분에 의해 방실결절이 불응기가 되어 Ectopic P Wave가 AVN을 지나지 못하는 경우 ; 6개 이상이 일련의 APCs 원인; Digitalis 중독시 P Wave Small, Spiked & Up in Lead II & III ST Segment Isoelectric 각 QRS Complex에 대해 하나 이상의 P Wave @ Multifocal Atrial Tachycardia(Chaotic Atrial Rhythm) ; Atria에 2개 이상의 Ectopic Pacemaker Rate; 100 - 200/min Abnormal P Wave * 진단 기준 조기에 Multiple Ectopic P Wave Irregular PR Interval Blocked P Wave Normal QRS Complex Atrial Rate; 100 - 200/min iii) (Paroxysmal) Nodal(= Junctional) Tachycardia(= PNT) @ Junctional Tachycardia ; 6개 이상의 접합부성기외수축이 빠르게 연속되어 일어나는 경우 Rate; 60 - 160/min * 진단 기준 Inverted P Wave가 QRS Complex에 선행되거나 그 직후에 일어나거나 또는 No P Wave Normal QRS Complex Rate; 60 - 160/min @ Junctional Accelerated Tachycardia; Rate; 160 - 220/min iv) (Paroxysmal) Ventricular Tachycardia; 4(or 6)개 이상의 일련의 PVC coronary artery disease 시에 DDx; Bundle Branch Block + Supraventricular Tachycardia * 진단 기준 최초 심박은 초기에 일어난다. No Ectopic P Wave Wide QRS Complex Rate; 100 - 250/min v) Supraventricular Tachycardia PAT & PNT 2> Flutter @ Atrial Flutter(심방조동) i) Single Ectopic Atrial Focus ii) 250 - 300/min or 220 - 350/min iii) 꺼꾸로 돌려보면 더욱 전형적인 모양이 된다 iv) F Wave(Flutter Wave; 조동파); Saw-Tooth Baseline v) Varying Rhythm vi) No real P Waves but, Multiple Ectopic Atrial Spikes vii) 진단 기준 F Wave; 220 - 350/min 심실의 반응 전도율이 일정한 경우; Regular 전도율이 변화하는 경우; Irregular Normal QRS Complex @ Ventricular Flutter i) 200 - 300/min or 150 - 300/min ii) Smooth Sine Curve; QRS Complex iii) 진단 기준 No Atrial Response; No P Wave No ST Segment, No T Wave Rate; 150 - 300/min 3> Fibrillation @ Atrial Fibrillation i) Multiple Ectopic Atrial Foci ii) f Wave(서동파); 너무 빨라 측정이 곤란하다. --거친 것 --가느다란 것 iii) Rate; 350 - 650/min iv) 진단 기준 f Wave; 350 - 650/min 심실의 흥분; Irregular, Irregular PR Interval Normal QRS Complex @ Ventricular Fibrillation i) 체순환으로의 혈액 구축이 불가능하다; 제일 응급 상태 ii) Multiple Ectopic Ventricular Foci iii) 진단 기준 No Atrial Response; No P Wave No QRS Complex Irregular Rhythm; 150 - 500/min 4) Heart Blocks 1> SA Block; Block 이전과 이후의 P Wave가 동일하다. i) 2o Degree Wenckebach Type * 진단 기준 Progressively Shorter PR Interval & Absent QRS Complex 심실휴지기는 PR Interval의 2배 이하 심실휴지기에는 P-QRS-T Wave가 없을 것 ii) 2o Mobitz Type * 진단 기준 Regular PP Interval 심실휴지기는 PR Interval의 2배 또는 그 이상의 정수배 심실휴지기에는 P-QRS-T Wave가 없을 것 2> AV Block PR Interval이 길어진다. > 0.2 sec i) First Degree(1o) AV Block PR Interval ≥ 0.2 sec Normal P-QRS-T wave Sequence ii) Second Degree(2o) AV Block 2 : 1 AV Block; QRS Complex 이전에 2개의 P Wave 3 : 1 AV Block; QRS Complex 이전에 3개의 P Wave @ High Grade AV Block ; 2개 이상의 연속적인 P Wave가 심실로 전달되지 않을 때 * 진단 기준 Regualr PR Interval 심실로 전달되지 않는 2개 이상의 연속적인 P Wave 심방세동 또는 조동이 있을때에는 오랜 휴지기간을 보이는 것 @ Wenckebach Type(Mobitz Type I) * 진단기준 Progressively Longer PR Interval & Absent QRS Complex Progressively Shorter RR Interval & Absent QRS Complex Regular PP Interval @ Mobitz Type II * 진단 기준 Regular PR Interval & Sometimes Absent QRS Complex iii) Third Degree(3o)(Complete) AV Block(= AV Dissociation)(Mobitz Type III) ; P Wave가 QRS Complex가 별개로 작용한다.(연관성이 없다.) * 진단 기준 No Relationship P Wave with QRS Complex Atrium과 Ventricle사이에 전도가 없다. Atrium; Sinus or Supraventricular Rhythm Ventricle; Junctional or Ventricular Escape Rhythm Atrial Fibrillation이 있으면 Junctional or Ventricular Escape Rhythm때문에 심실박동수가 일정하게 느껴진다. @ Stokes-Adams Syndrome; 3rd Degree(3o) AV Block 에서 심실의 수축이 너무 느려서 뇌로가는 혈액의 유량이 감소하여 의식을 잃게되는 경우 3> Bundle Branch Block; 존재시에는 QRS Vector 와 Ventricular Hypertrophy를 진단할수 없다. Wide QRS Complex(사지유도에서) ≥ 0.12 sec R-R' Configuration(좌우흉부유도에서) i) Right Bundle Branch Block(RBBB); Lead I, V1-2 RVH를 진단할수 없다. Wide QRS Complex; > 0.12 sec Inverted T Wave ST Segment Depression V1,2; RsR' Lead I; QRS Complex, Large S Wave ii) Left Bundle Branch Block(LBBB); Lead I, aVL, V1, V5, V6 LVH를 진단할수 없다. Wide QRS Complex; > 0.12 sec Inverted T Wave ST Segment Depression V5,6; RR'; EKG 상에서 Infarction을 정확히 진단할수 없다. Lead I, aVL, V5-6; No Normal Septal Q Wave V1; qrS Wave @ Hemiblock; Left Bundle Branch의 Anterior or Posterior Division 의 Block 1) Anterior Hemoblock Anterior Division of Left BB 의 block 1/2 of Anterior Infarction i) LAD; < -40o; without Inferior Wall Infarction ii) slighted Widened QRS Complex; 0.1 - 0.12 sec iii) Q1S3; Lead I; Q Wave Lead III; Wide Deep S Wave iv) with LVH; aVL; Large R Wave ≥ 16 mm 2) Posterior Hemiblock i) RAD; > 120o; without RVH ii) Normal or Slightly Widened QRS Complex iii) S1Q3; Lead I; Wide S Wave Lead III; Q Wave 3) Bifascicular Blocks i) RBBB + Anterior Hemiblock LAD < - 40o Wide QRS Complex ≥ 0.12 sec Lead I; Wide S Wave V1; Positive QRS Complex ii) RBBB + Posterior Hemiblock RAD ≥ 120o Wide QRS Complex ≥ 0.12 sec Lead I; Wide S Wave V1; Positive QRS Complex iii) RBBB or LBBB & 1o AV block(PR Interval ≥ 0.2 sec) RBBB + PR Interval ≥ 0.2 sec Wide QRS Complex ≥ 0.12 sec Lead I; Wide S Wave V1; Positive QRS Complex LBBB + PR Interval ≥ 0.2 sec Wide QRS Complex ≥ 0.12 sec No Septal Q Wave; Lead I, aVL, V5-6 V1; Negative QRS Complex iv) Alternating RBBB or variable LBBB; Anterior Hemiblock + Posterior Hemiblock(= LBBB) 4) Intermittent Blocks; with at least one normal, non-blocked fascicle i) RBBB + Anterior Hemiblock + Intermittent Posterior Hemiblock ii) RBBB + Posterior Hemiblock + Intermittent Anterior Hemiblock iii) Anterior Hemiblock + Posterior Hemiblock(= LBBB) + Intermittent RBBB iv) RBBB + Intermittent LBBB Intermittent Blocks of one fascicle; continuous EKG pattern of normal with intermittent signs of block Intermittent Blocks of two fascicles; intermittent EKG signs of both blocks Intermittent Blocks; one intermittent + one permanant Block; continous EKG pattern of one block & intermittent signs of another Block 5) Mobitz II; Ventricular non-conduction 4> Aberrant Conduction; 변형 QRS Complex ; 두 심실 사이에 불응기의 차이가 있어서 약간의 전도 지연이 있는 경우 Wide QRS Complex i) 원인 선행자극직후의 APCs or JPCs Aschman Phenomenon; Atrial Fibrillation시에 ; Long RR Interval후 Short RR Interval이후의 변형 QRS Complex ii) 진단 기준 APCs with Aberrant Conduction; Premature Ectopic P Wave가 Wide Aberrant QRS Complex에 선행 JPCs with Aberrant Conduction; Premature Inverted P Wave가 Wide Aberrant QRS Complex직전 또는 직후에 Atrial Fibrillation with with Aberrant Conduction; Long RR Interval후 Short RR Interval이후의 Wide Aberrant QRS Complex @ Critical Rate; 어떤 특정한 빠른 속도에 도달했을 때만 각 블럭이 생기는 경우 @ Incomplete BBB Normal QRS Complex R-R' Configuration @ Wolff-Parkinson-White(WPW) Syndrome Accessory Pathway(Bundle of Kent) Delta Wave --Positive --Negative ; Accessory Pathway 에 의해 심실을 자극하는데 걸리는 정상적 지연이 짧아져 유발된 Premature Ventricular Depolarization(조기 심실 탈분극) * 진단 기준 Short PR Interval Wide Irregular QRS Complex Delta Wave Sometimes Supraventricular Tachycardia 7. Axis 1) Vector Left Ventricle > Right Ventricle Septum; Left > Right 2) Mean QRS Complex Vector 기시부; AV node Downward & to Left & Posterior Normal Range; 0 - +90o, 0 - +110o Ventricle Hypertrophy; 같은 방향으로 Deviation Cardiac Infarction; 반대 방향으로 Deviation 3) Right Axis Deviation(RAD); +110o - ± 180o URQ + ULQ Lead I; QRS Complex Negative * RAD의 원인 1) 마른 체형 2) 우심실 비대 3) 폐질환 4) Extreme Right Axis Deviation; URQ 5) Left Axis Deviation(LAD); - 30o - - 90o ULQ 1> Lead I 2> AVF * LAD의 원인 1) Left Ventricular Hypertrophy 2) Horizontal Heart 3) Inferior Infarction 4) Anterior Hemiblock 5) Anterior Hemiblock + RBBB 8. Hypertrophy 1) Atrial Hypertrophy 원인; Mitral Stenosis V1; Diphasic P Wave 1> Right Atrial Hypertrophy; V1 P Wave의 Large Initial Component Lead II; P Wave Height ≥ 2.5 mm 2> Left Atrial Hypertrophy; V1 P Wave의 Large Terminal Component, Depth ≥ 3> Both Atrial Hypertrophy; RAH + LAH 2) Ventricular Hypertrophy 1> Right Ventricular Hypertrophy i) V1; Large R Wave & small S Wave ii) RAD iii) V6; Deep S Wave iv) V1 R Wave + V6 S Wave ≥ 11 mm vi) Right Chest Lead ST Segment Depression Asymmetric Inverted T wave 2> Left Ventricular Hypertrophy i) Large QRS Complex ii) LAD iii) V1; Large S Wave + V5; Large R Wave ≥ 35 mm iv) I, aVL, V5-6; Large R Wave V1-2; Large S Wave vi) V5 or V6 R Wave ≥ 27 mm vii) aVL R Wave ≥ 11 mm v) Left Chest Leads(V5,6); 원인 불명 Inverted Asymmetric T Wave(Long Gradual, Rapid) ST Segment Depression 3> Both Ventricular Hypertrophy 9. Infarction @ 3‘I’s or Triad of Acute Myocardial Infarction(급성 심근 경색) 1) Ischemia; 허혈; Reversible 1> Inverted Symmetric T Wave; 1st 2> ST Segment Depression 2) Injury; 손상; Reversible 1> ST Segment Elevation; 2nd; means Acute or Recent 2> ST Segment Normal; Chronic 3) Infarction; 경색; Q Wave; 3rd Abnormal Q Wave 1> Width ≥ 0.04 sec 2> Height ≥ 1/3 of R Wave Septal Q Wave; Normal Lead I, aVL, V5-6 @ Pericarditis ST Segment Elevation T Wave; Normal @ Ventricular Aneurysm ST Segment Elevation(Irreversible) @ Types of Infarction 1> Anterior Wall Infarction; LCA의 AD Branch i) V1-4 or V2-6; Q Wave ii) Acute; V1-2; Q Wave or ST Segment Elevation * Anterior Wall Septal Infarction V1,2에만; Q Wave or V1-2; poor R Wave Progression 2> Lateral Wall Infarction; Left Coronary Artery 의 Circumflex Branch I, AVL, V5-6; Q Wave 3> Inferior(= Diaphragmatic) Wall Infarction II, III, AVF; Q Wave 4> Posterior Wall Infarction; Anterior Wall Infarction 과는 정확히 반대가 된다. V2-4R; Q Wave Acute; V1-3; ST Segment Depression Large R Wave V6; Q Wave Arrhythmia잘 동반; Dangerous 5> Right Ventricle V1,2; Q Wave 10. Miscellaneous 1) Pulmonary Disease 1> Emphysema i) Low Voltage ii) RAD 2> Pulmonary Infarction i) Lead I; Large S Wave ii) Lead II; ST Segment Depression iii) Lead III; Large Q Wave iv) V1-4; Inverted T Wave v) Transient RBBB 3> S1Q3 Syndrome; Pulmonary Infarction 의 결과로 오는 급성 폐성심(Acute Cor Pulmonale) i) Lead I; Large S Wave ii) Lead III; Q Wave 2) Electrolytes Disturbances; ST Segment Abnormality 1> Potassium(K+) i) Hyperkalemia Moderate Wide Flat P Wave Wide QRS Complex Peaked T Wave Extreme No P Wave Widened QRS Complex ii) Hypokalemia; ST Segmrnt Depression Moderate Flat T Wave U Wave Extreme Inverted T Wave Prominent U Wave 2> Calcium(Ca2+) i) Hypercalcemia; Short ST Segment Short QT Interval ii) Hypocalcemia; Widened ST Segment Prolonged QT Interval 3) Patterns 1> Ventricular Strain Waxy Depressed ST Segment; 위로 커브를 그리며 ST 분절 중간에서 점점 위로 굽어진다. i) Right Ventricular Strain ii) Left Ventricular Strain 2> Artificial Pacemaker; Electrical Spikes직후에 Ventricular Response i) Transverse Pacemaker(= Right Ventricular Pacemaker); 가장 널리 사용 All have LBBB pattern QRS If LAD; Pacemaker in Apex of Right Ventricle; 가장 이상적인 위치 If Normal Axis; Pacemaker in Right Ventricular Mid-Outflow Tract If RAD; Pacemaker in Right Ventricle, below pulmonic Valves ii) Epicardiac Pacemaker(= Left Ventricular Pacemaker) RBBB 형태의 QRS RAD iii) Demand Pacemaker iv) Atrial Pacemaker v) P Wave Triggered Pacemaker(= Atrial Synchronous Pacemaker) vi) Sequential AV Pacemaker 3> Subendocardial Infarction; Flat ST Segment Depression 4> Pericarditis i) QRS Complex의 합이 음성을 보이는 유도(대개 우측흉부유도) Flat or Concave Elevated ST Segment - Inverted T Wave ii) QRS Complex의 합이 양성을 보이는 유도(유도 I, II 등) Elevated ST Segment & T Wave Off Baseline 5> Early Repolarization; Normal Variant i) Left Chest Lead; V4-6 ii) Elevated ST Segment 6> Dextrocardia; Lead I, aVR, V1-6 i) Lead I; Inverted QRS Complex(or P Wave, T Wave); Negative ii) V1; Highest R Wave V6; Smallest R Wave iii) aVR; Inverted QRS Complex(or P Wave, T Wave); Positive 7> Pediatric ECG; 대략 1년후 성인 ECG와 유사하게 된다. i) RVH ii) RAD iii) V1-3; Inverted T Wave 4) Drugs 1> Digitalis; Lead I, V5-6 i) Excess Digitalis; Hypokalemia에 의해 Exaggerated 된다. SA Block PAT with Block AV Block Tachycardia with AV Dissociation Scooping(국자모양) ST Segment Flat or Inverted T Wave ii) Digitalis Toxicity PVC Bigeminy, Trigeminy etc Ventricular Tachycardia Ventricular Fibrillation 2> Quinidine; 심근으로 통하는 전기전도(Electrical Conduction)를 느리게 함 심실의 재분극 시간이 길어진다. i) Quinidine Effects Wide, Notched P Wave Wide QRS Complex ST Depression Wide QT Interval U Wave ii) Quinidine Toxicity; Roller Coaster Patterns |
| ECG | electrocardiogram, electrocardiography |
| ECGF | endothelial cell growth factor |
| ECGS | endothelial cell growth supplement |
| ECH | educator contact hour |
| ECHO | echocardiography; enteric cytopathic human orphan [virus]; Etoposide, cyclophosphamide, Adriamycin, and vincristine |
| EC | electrochemical detection |
|---|---|
| EC | enriched condition |
| Ec | erythrocyte |
| EC | eyes closed |
| EC 4.2.1.17 | enoyl-CoA hydratase |
| EC SOD | Extracellular superoxide dismutase |
| EC(50) | effect |
| EC-SOD | extracellular SOD |
| EC/IC | Extracranial-Intracranial |
| EC50 | Effective concentrations |
| ecdemic | <epidemiology> Denoting a disease brought into a region from without. Origin: G. Ekdemos, foreign, from home, fr. Demos, people (05 Mar 2000) |
|---|---|
| ecderon | <anatomy> The external layer of the skin and mucous membranes; epithelium; ecderon. Ecteron"ic. See: Ect-. Source: Websters Dictionary (01 Mar 1998) |
| ecdysial gland | <entomology> Insect structures that originate from the ectoderm of the ventrocaudal part of the head and serve as a source of ecdysone. Synonym: peritracheal glands, prothoracic glands, thoracic glands, ventral glands. (05 Mar 2000) |
| ecdysiasm | A morbid tendency to undress to produce sexual desire in others. Origin: fr. G. Ekdyo, to remove one's clothes (05 Mar 2000) |
| ecdysis | Origin: NL, fr. Gr. 'ekdysis a getting out, fr. 'ekdyein, to put off; 'ek out + dyein to enter. <biology> The act of shedding, or casting off, an outer cuticular layer, as in the case of serpents, lobsters, etc.; a coming out; as, the ecdysis of the pupa from its shell; exuviation. Source: Websters Dictionary (01 Mar 1998) |
| ecdysone | <endocrinology> Family of steroid hormones found in insects, crustaceans and plants. In insects, _ ecdysone stimulates moulting. The steadily maturing character of the moults is affected by steadily decreasing levels of juvenile hormone. _ ecdysone (ecdysterone) has a slightly different structure and is also found widely. Phytoecdysones are synthesised by some plants. (18 Nov 1997) |
| ecdysone dehydrogenase-isomerase | <enzyme> Converts alpha-ecdysone to less active 3-epiecdysone, using NADP Registry number: EC 1.1.1.- (26 Jun 1999) |
| ecdysteroid 26-hydroxylase | <enzyme> Converts ecdysone to 26-hydroxyecdysone in the presence of NADPH Registry number: EC 1.14.13.- (26 Jun 1999) |
| ecdysteroid UDP-glucosyltransferase | <enzyme> From the baculovirus lymantria dispar multinucleocapsid nuclear polyhedrosis virus (ldmnpv); mw 55 kD; isoelectric point 7.6; genbank u04321 Registry number: EC 2.4.1.- Synonym: egt gene product (26 Jun 1999) |
| ecdysterone | <chemical> 2 beta,3 beta,14,20,22r,25-hexahydroxy-5 beta-cholest-7-en-6-one. An insect hormone which is active during the molting stage of the insect's development. Chemical name: Cholest-7-en-6-one, 2,3,14,20,22,25-hexahydroxy-, (2beta,3beta,5beta,22R)- (12 Dec 1998) |
| ECF | <abbreviation> Extracellular fluid. (05 Mar 2000) |
| ECF-A | <abbreviation> Eosinophil chemotactic factor of anaphylaxis. (05 Mar 2000) |
| ECFV | <abbreviation> Extracellular fluid volume. (05 Mar 2000) |
| ECG | <cardiology, investigation> An recording of the electrical activity of the heart on a moving strip of paper. The electrocardiogram detects and records the electrical potential of the heart during contraction. Acronym: ECG (13 Nov 1997) |
| ECG lead | An electrocardiographic cable with connections within the electronics of the machine designated for an electrode placed at a particular point on the body surface. (05 Mar 2000) |
Synonyms : NSC-526417, NSC 526417, NSC526417
Synonyms :
Synonyms : Echinostoma ilocanum, Euparyphium ilocanum, Fascioletta ilocanum
Synonyms :
Synonyms : Echinostomiases
제품명 |
판매사 |
보험코드 | 성분/함량 | 구분/보험급여 |
|---|---|---|---|---|
|
스킨힐지크림 - 새창
|
코오롱제약 |
A04702751 | Econazole Nitrate, Gentamicin Sulfate, Triamcinolone acetonide | 전문의약품 | 삭제 |
|
에치나캅셀 - 새창
|
삼공제약 |
A14100511 | Aluminum Aspirin, Diphenylpyraline HCl, Lysozyme Chloride | 일반의약품 | 삭제 |
|
나시론큐크림 - 새창
|
삼공제약 |
A14101091 | Econazole Nitrate, Gentamicin Sulfate, Triamcinolone acetonide | 전문의약품 | 삭제 |
|
두루겐크림 - 새창
|
다림바이오텍 |
A11250041 | Econazole Nitrate, Gentamicin Sulfate, Triamcinolone acetonide | 전문의약품 | 삭제 |
|
에코젠크림 - 새창
|
한국마이팜 |
A19690061 | Econazole Nitrate, Gentamicin Sulfate, Triamcinolone acetonide | 전문의약품 | 삭제 |
|
겐타나졸크림 - 새창
|
한국넬슨제약 |
A18450211 | Econazole Nitrate, Gentamicin Sulfate, Triamcinolone acetonide | 전문의약품 | 삭제 |
|
코무스크림 - 새창
|
한국알리코팜 |
A06650841 | Econazole Nitrate, Gentamicin Sulfate, Triamcinolone acetonide | 전문의약품 | 삭제 |
|
에코신캅셀 - 새창
|
쎌라트팜코리아 |
A23450551 | Chlorpheniramine Maleate, Diprophylline, Methoxyphenamine HCl, Noscapine | 전문의약품 | 삭제 |
|
에코론지크림 - 새창
|
한미약품 |
A21401571 | Econazole Nitrate, Gentamicin Sulfate, Triamcinolone acetonide | 전문의약품 | 삭제 |
|
동화후실론크림 - 새창
|
동화약품공업 |
A05704921 | Econazole Nitrate, Gentamicin Sulfate, Triamcinolone acetonide | 전문의약품 | 삭제 |
| eczema herpeticum |
eczema characterized by a feverish condition and widespread eruption of vesicles; most common in children
출처: wordnet.princeton.edu/perl/webwn
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|---|---|
| eclampsia |
a toxic condition characterized by convulsions and possibly coma during or immediately after pregnancy
출처: wordnet.princeton.edu/perl/webwn
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| ec- |
European Union: an international organization of European countries formed after World War II to reduce trade barriers and increase cooperation among its members; "he took Britain into Europe"
출처: wordnet.princeton.edu/perl/webwn
|
| eccentricity |
strange and unconventional behavior (geometry) a ratio describing the shape of a conic section; the ratio of the distance between the foci to the length of the major axis; "a circle is an ellipse with zero eccentricity" a circularity that has a different center or deviates from a circular path
출처: wordnet.princeton.edu/perl/webwn
|
| eclectic |
someone who selects according to the eclectic method selecting what seems best of various styles or ideas
출처: wordnet.princeton.edu/perl/webwn
|
| EC | (ecology) the process by which a plant or animal becomes established in a new habitat |
|---|---|
| EC | liquid containing proteins and electrolytes including the liquid in blood plasma and interstitial fluid |
| EC | a graphical recording of the cardiac cycle produced by an electrocardiograph |
| EC | a diffraction grating consisting of a pile of plates of equal thickness arranged stepwise with a constant offset |
| EC | a body of troops arranged in a line |
| EC | fishes having a sucking disk on the head for clinging to other fishes and to ships |
| EC | type genus of the Echeneididae: typical remoras |
| EC | remoras found attached to sharks |
| EC | burrowing spine-covered monotreme of Australia having a long snout and claws for hunting ants and termites |
| EC | New Guinea echidnas |
| EC | a genus of Siphonaptera |
| EC | parasitic on especially the heads of chickens |