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心电解惑
$64.33
从细胞电生理阐述心电图的...
从细胞电生理阐述心电图的产生机制,让判读心电图更容易些,让临床现象的原因更清楚。附有少见病例,便于学习。
本书从心电基础出发,将电与心脏结构相结合进行逻辑推理,使读者能轻松理解心电现象,并能帮助读者实现“知其然而知其所以然”。本书分为上下两篇,上篇从心电图到疾病,下篇介绍疾病的心电图表现。本书图文结合,采用“具体病例 病例解析 知识点”的形式进行介绍,进一步加深对典型及疑难病例的理解。本书适合临床各科一线医师,尤其适合心内科医师、心电图室医师、急诊科医师阅读。
赵运涛,北京大学航天中心医院,中国心电学会无创心脏电生理专业委员会常委;北京医学会心电生理和起搏分会青年委员会委员,副主任医师,北京大学医学博士,现任职于北京大学航天中心医院心内科。现任中国心电学会无创心脏电生理专业委员会常委;北京医学会心电生理和起搏分会青年委员会委员。《心电图杂志(电子版)》常务编委。以首位作者发表SCI论文18篇,分别发表于《Annals of Internal Medicine》,《BMJ》(case review)及《circulation》(cases and traces)等国际杂志。《Annals of Internal Medicine》、《Heart》及《Plos One》审稿人。
上篇 从心电图到疾病 1第1章 心电学基础 2专题一 心律失常的电生理基础 2专题二 心脏的传导系统 7专题三 心脏电生理学基础 10第2章 P波 14专题一 易被忽略的阻滞类型——房间阻滞 14专题二 房颤也有真假:无规律的不等与规律的不等(irregularly irregular VS regularly irregular) 18 第3章 PR间期与PR段 25专题一 众里寻“Ta”千百度:心房复极波(Ta)与ST段抬高 25专题二 没想到,旁道前传竟会这样“伤” 29专题三 从心电图诊断主动脉瓣感染性心内膜炎 34 第4章 QRS波 37专题一 室性心动过速的定位诊断 37专题二 窄QRS 波心动过速也可以是室速 43专题三 宽QRS 波心动过速不一定就是室速 49专题四 心动过速性心肌病:double fire,不同寻常的病因 54专题五 怎样区别新发或陈旧性左束支传导阻滞 59专题六 LBBB还有分型 66专题七 容易被人忽略的胸痛病因——左束支传导阻滞 71专题八 不可思议!运动也会诱发疼痛的左束支传导阻滞 74专题九 V1导联高R波到底对应于左心室壁何处梗死?如何确定梗死相关血管? 77 第5章 ST段 82专题一 正本溯源——左主干缺血心电图:“8 2”而非“6 2” 82专题二 “8 2 现象”就是左主干病变? 88专题三 急性左主干完全闭塞心电图呈STEMI表现 92专题四 胸导联ST段抬高伴T波倒置:并非是急性前壁心肌梗死 94专题五 V1~V3导联ST段抬高就是前壁心肌梗死吗? 99专题六 不要惧怕ST段抬高 104专题七 急性脑血管病出现ST-T改变是心肌梗死吗? 107专题八 ST段抬高的奇特病因——膈肌上抬 111专题九 心脏肿瘤也可以导致ST段抬高 117专题十 奇葩ST 段抬高——心包缺陷 121专题十一 Brugada拟表型的其他原因——心脏受压 125专题十二 “尖顶军盔征”—— 一种不被人知晓的心电图波形 129专题十三 谁前谁后?Takotsubo综合征与“尖顶军盔征” 133专题十四 想知道的所有de Winter综合征的心电图表现全在这里 136第6章 T波 145专题一 一招搞定全导联T 波倒置 145专题二 根据胸导联T 波定位罪犯血管 152专题三 从T波电交替到机械交替 157专题四 急诊心电图正常的典型胸痛真的可以掉以轻心吗? 161专题五 运动员的T 波倒置 165下篇 疾病的心电图表现 171第7章 肺栓塞 172专题一 这种肺栓塞心电图,死神在向他招手 172专题二 揭开肺栓塞“V1~V3导联ST段抬高”的神秘面纱 179专题三 诊断肺栓塞的蛛丝马迹——V1~V3和下壁导联T波倒置 185 第8章 房室阻滞 190专题一 2∶1房室阻滞:电和机械的秘密 190专题二 2∶1房室阻滞背后的秘密——心脏结节病 195专题三 体表心电图的盲区——假性2∶1房室阻滞 201专题四 揭秘罕见、危险的房室阻滞——运动诱发的房室阻滞 203专题五 你听说过激素治疗房室阻滞吗? 209专题六 被“感染”的心电图——可逆性房室阻滞 213专题七 不按常理的文氏现象 218第9章 高钾血症 222专题一 谁动了我琴弦——高钾血症引起的“室扑” 222专题二 高钾血症诱导的Brugada 波 228第10章 应激性心肌病 232专题一 从“急性前壁心肌梗死”中识别应激性心肌病 232专题二 急性前壁心肌梗死VS应激性心肌病秒杀技巧背后的秘密 236 第11章 电与结构不匹配的心肌淀粉样变性 243第12章 淋巴瘤浸润性心肌病 254第13章 肥厚型心肌病 258专题一 心电图就可以诊断心尖肥厚型心肌病?远远不够! 258专题二 室间隔中部梗阻肥厚型心肌病 262专题三 一例罕见的肥厚型心肌病——合并室壁瘤、室壁瘤内血栓、左心室中部梗阻及室速 274专题四 利用室性早搏的血流动力学改变诊断隐匿性肥厚型梗阻性心肌病 282 第14章 肌营养不良与心肌病 286第15章 洋地黄中毒 291专题一 见鬼了,地高辛浓度正常的中毒 291专题二 洋地黄中毒导致房速合并房室阻滞 295第16章 其他 298专题一 “除”不掉的室速 298专题二 LAD近段闭塞的两种不同的梗死——广泛前壁和前间壁 302专题三 诊断了这么多年的右心室梗死,其实并不存在 304专题四 吞咽诱发晕厥 307专题五 不是所有的R-on-T型室早都那么可怕 310专题六 起搏器心电图——如何鉴别T 波记忆与缺血性T 波 314专题七 去伪存真——别让这些心电图波形骗过你的眼睛 319专题八 糖皮质激素的第十一宗“罪” 326专题九 “揭秘”心脏震击猝死综合征的特殊类型——缓慢型心律失常 331
循环系统疾病仍是威胁人类健康的主要疾病之一。心电图作为临床诊断疾病的手资料,可以在早期预测许多危及生命的疾病。然而近几年来心电图学日新月异的发展,许多新鲜命名及崭新的定义令人目不暇接,在这种情况下,临床及心电图工作者必须有一定深度的知识更新才能更好地辅助临床工作及避免临床中出现误诊、漏诊。在这种形式下,我们通过“Case Discussion”的形式,展示我们团队发表在国外期刊上的病例报道,并结合一些令人颠覆眼球的“Case”,阐述相关理论,深入讲解一些罕见及疑难疾病的新心电图概念,和不同于传统认识下的一些新情况,甚至有些概念会颠覆传统认知,甚至亲自致信ESC 组委会,明确一些指南中的一些错误,从而正本清源。而且本书抛弃以往心电图书中只谈电忽略了结构的弊端,将电与心脏结构相结合,力求让读者能知其然而知其所以然。本书分为上下两篇,上篇从心电图到疾病,第1章主要阐明心电图的解剖以及电生理基础;第2~6章通过阐述心电图各个波形的异常变化,结合具体相关病例报告以不同的角度阐明波形变化的临床意义,使读者耳目一新,知常达变,对心电图各种波形有更全新的认识。下篇介绍几种疾病的心电图表现,第7~16章阐述各种临床少见及常见疾病的典型以及不典型心电图改变,以及快速应用心电图的相关方法。本书有两个特点:一是具体病例 病例解析 知识点,进一步加深对典型及疑难病例的理解;二是从心电基础出发,进行逻辑推理,像福尔摩斯探案一样,力求实现心电解惑。本书适合内科多学科医师参阅,不局限于心血管内科医师,尤其适用于急诊、临床一线医师。另外,本书中一些新概念对心电图医生来说,也可以更好地辅助临床;对在读学生而言,更能提高知识层面,提高对心电图的兴趣。感谢我们团队成员的辛勤写作,并感谢心在线的大力支持。限于我们水平,仍难免有不足之处,恳请各位同仁、读者不吝指正。也希望读者们能够一如既往地喜爱本书并多提宝贵意见和建议,以备再版时参考。赵运涛2018年冬
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