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Clinical Disorders: Difference between revisions
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==Medication== | ==Medication== | ||
===Digoxin=== | ===Digoxin=== | ||
[[Image:med_digitalis.png|thumb|Typical for digoxin intoxication is the odd shaped ST-depression]] | [[Image:med_digitalis.png|thumb|300px|Typical for digoxin intoxication is the odd shaped ST-depression]] | ||
ECG changes typical for digoxin intoxication (digoxin = Lanoxin) are: | ECG changes typical for digoxin intoxication (digoxin = Lanoxin) are: | ||
*odd shaped ST-depression. | *odd shaped ST-depression. | ||
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Intoxication can lead to a SA-block or AV-block, sometimes in combination with a tachycardia. '''NB''' these effects are increased by hypokaliemia. In extreme high concentrations rhythmdisturbances (''ventricular tachycardia, ventricular fibrillation, atrial fibrillation'') may develop. | Intoxication can lead to a SA-block or AV-block, sometimes in combination with a tachycardia. '''NB''' these effects are increased by hypokaliemia. In extreme high concentrations rhythmdisturbances (''ventricular tachycardia, ventricular fibrillation, atrial fibrillation'') may develop. | ||
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===Anti-arhythmics=== | ===Anti-arhythmics=== | ||
* '''anti-arhythmics:''' These may lead to several ECG-changes; | * '''anti-arhythmics:''' These may lead to several ECG-changes; | ||
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=== Nortriptyline intoxication === | === Nortriptyline intoxication === | ||
[[Image:ECG_nortr_intox.png|thumb| An example of severe nortriptyline intoxication. The inhibitory effect of the sodiumchannel manifests as a broadened QRS complex and a prolonged QT interval.]] | <div align="center"> | ||
[[Image:ECG_TCA_intox.jpg|thumb| Another example of severe nortriptyline intoxication.]] | {| | ||
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[[Image:ECG_nortr_intox.png|thumb|left|300px|An example of severe nortriptyline intoxication. The inhibitory effect of the sodiumchannel manifests as a broadened QRS complex and a prolonged QT interval.]] | |||
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[[Image:ECG_TCA_intox.jpg|thumb|left|300px| Another example of severe nortriptyline intoxication.]] | |||
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=== Amitriptyline intoxication === | === Amitriptyline intoxication === | ||
[[Image:ECG_amitr_OD_during.jpg|thumb| An example of a severe amitriptylin intoxication. The inhibitory effect of the sodiumchannel manifests as a broadened QRS complex.]] | <div align="center"> | ||
[[Image:ECG_amitr_OD_before.jpg|thumb| An ECG of the same patient before the intoxication.]] | {| | ||
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[[Image:ECG_amitr_OD_during.jpg|thumb|300px| An example of a severe amitriptylin intoxication. The inhibitory effect of the sodiumchannel manifests as a broadened QRS complex.]] | |||
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[[Image:ECG_amitr_OD_before.jpg|thumb|300px| An ECG of the same patient before the intoxication.]] | |||
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==Hypothermia== | ==Hypothermia== | ||
[[Image:osborne.png|thumb| An Osborne J wave]] | [[Image:osborne.png|thumb|left|250px| An Osborne J wave]] | ||
<div style="float:right"> | |||
<gallery> | |||
Image:osborne_ecg.jpg|A 12 lead ECG of a patient with a body temperature of 32 degrees Celsius. Note the sinusbradycardia, the prolonged QT interval (QTc is not prolonged) and the Osborne J wave, most prominantly in leads V2-V5 | |||
Image:JJ0001.jpg|An ECG of a patient with a body temperature of 28 degrees Celsius. | |||
</gallery> | |||
</div> | |||
In hypothermia a number of specific changes can be seen;<cite>hypoth</cite> | In hypothermia a number of specific changes can be seen;<cite>hypoth</cite> | ||
* sinubradycardia | * sinubradycardia | ||
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* ST-elevation (inferior and left precordial leads) | * ST-elevation (inferior and left precordial leads) | ||
* Osborne-waves (slow deflexions at the end of the QRS-complex) | * Osborne-waves (slow deflexions at the end of the QRS-complex) | ||
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See: [[Conduction_delay|Conduction delay]] | See: [[Conduction_delay|Conduction delay]] | ||
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==References== | ==References== | ||
<biblio> | <biblio> | ||
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#hypoth pmid=2738372 | #hypoth pmid=2738372 | ||
</biblio> | </biblio> | ||
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[[Category:ECG Textbook]] | |||