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L’ECG
10 messages incontournables

Dr Mahmoudi.F

Eloued
OBJECTIF
ne pas passer à côté d’un IDM !!!
 sus décalage ST ≠ IDM !!!
 onde T négative ≠ urgence !!!
 Bradycardie ≠ urg...
0
1
25

10
2
Sténoses coronaires sévères ?


l’ECG ne détecte pas toute
cardiopathie



Un ECG normal n’élimine pas une
cardiopathie



un ECG normal n’élimine pa...
3
LE RYTHME


Le rythme ?

Mécanisme électrophysiologique à l’origine de la
contraction des ventricules. A ne pas confondre...
chaque complexe QRS est précédé par
une onde P et chaque onde P est suivie
par un complexe QRS. L’onde P doit
avoir les ca...
D2 +
V1
4
Onde P
visible
P pulmonaire

P large

P mitrale
Dissociation AV
5
Onde P
absente
EXTRASYSTOLE
VENTRICULAIRE
tachyACF
A
6

Un QRS large en rythme sinusal évoque :
-un trouble de conduction
intraventriculaire
BBG BBD
BBD
BBG
7
Segment ST
DECALAGE ST

sus
J
J

sous
 Troubles

secondaires de
repolarisation

tachycardie,bloc de branche, surcharge
ventriculaire ouhypertrophie
ventriculai...
TERRITOIRES …
AVEC LE TEMPS
….!!
RABOTAGE DE L’ONDE R
8
ONDES

R.S
9
TACHYCARDIE
A QRS FINS
10
LA MORT
TV
MERCI
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
ECG   LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"
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ECG LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"

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ECG LA LECTURE PRATIQUE POUR LES DEBUTANTS " Dr MAHMOUDI.F"

  1. 1. L’ECG 10 messages incontournables Dr Mahmoudi.F Eloued
  2. 2. OBJECTIF ne pas passer à côté d’un IDM !!!  sus décalage ST ≠ IDM !!!  onde T négative ≠ urgence !!!  Bradycardie ≠ urgence atropine !!  Tachycardie ≠ injection IV  HVG BBG BBD ≠ urgence 
  3. 3. 0
  4. 4. 1
  5. 5. 25 10
  6. 6. 2
  7. 7. Sténoses coronaires sévères ?
  8. 8.  l’ECG ne détecte pas toute cardiopathie  Un ECG normal n’élimine pas une cardiopathie  un ECG normal n’élimine pas « surtout » une coronaropathie
  9. 9. 3
  10. 10. LE RYTHME  Le rythme ? Mécanisme électrophysiologique à l’origine de la contraction des ventricules. A ne pas confondre avec la fréquence cardiaque qui est le nombre de battements par minute.  Sinusal ? Rythme qui naît des cellules du nœud sinusal. Les impulsions sont transmises aux ventricules et responsables de leurs dépolarisations
  11. 11. chaque complexe QRS est précédé par une onde P et chaque onde P est suivie par un complexe QRS. L’onde P doit avoir les caractéristiques d’une onde P sinusale … D2 V1
  12. 12. D2 + V1
  13. 13. 4
  14. 14. Onde P visible
  15. 15. P pulmonaire P large P mitrale
  16. 16. Dissociation AV
  17. 17. 5
  18. 18. Onde P absente
  19. 19. EXTRASYSTOLE VENTRICULAIRE
  20. 20. tachyACF A
  21. 21. 6
  22. 22.  Un QRS large en rythme sinusal évoque : -un trouble de conduction intraventriculaire
  23. 23. BBG BBD
  24. 24. BBD
  25. 25. BBG
  26. 26. 7
  27. 27. Segment ST
  28. 28. DECALAGE ST sus J J sous
  29. 29.  Troubles secondaires de repolarisation tachycardie,bloc de branche, surcharge ventriculaire ouhypertrophie ventriculaire, faisceau accessoire, stimulateur cardiaque
  30. 30. TERRITOIRES …
  31. 31. AVEC LE TEMPS ….!!
  32. 32. RABOTAGE DE L’ONDE R
  33. 33. 8
  34. 34. ONDES R.S
  35. 35. 9
  36. 36. TACHYCARDIE A QRS FINS
  37. 37. 10
  38. 38. LA MORT
  39. 39. TV
  40. 40. MERCI

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