심전도학 및 실습

Chapter 1. 심장의 해부생리 / 7

* Ⅰ. 심장(Heart) ··················································· 9
* Ⅱ. 순환계의 구성 ··············································· 12
* Ⅲ. 심장의 전기생리학 ········································· 15
* Ⅳ. 심장(Heart)의 특성 ······································· 19
* Ⅴ. 불응기와 과도정상기 ······································ 22

Chapter 2. 심전도의 정의 / 25

* Ⅰ. 심전도(ECG)의 기본용어 ································ 29
* Ⅱ. 심전도 검사 시 전극 부착위치 ························· 30
* Ⅲ. 심장의 전기발생 ··········································· 33
* Ⅳ. 표준(Standard) 12 유도(Lead)의 구성 ·············· 34
* Ⅴ. 에인트호벤의(W. Einthoven's) 정삼각형(Triangle) 법칙 ···· 42
* Ⅵ. 각각의 유도가 반영하는 심장의 부위 ················ 43
* Ⅶ. 유도전극(Lead electrode) 부착 시 주의사항 ······ 44
* Ⅷ. 심전도 기록의 실제 ······································· 45

Chapter 3. 심전계 / 51

* Ⅰ. 교정(Calibration) ·········································· 53
* Ⅱ. 시정수 ························································· 53
* Ⅲ. Microshock & Macroshock ··························· 54

Chapter 4. 심전도 파형 / 55

* Ⅰ. 심전도의 이해 ·············································· 57
* Ⅱ. 심전도 기록용지 ··········································· 60
* Ⅲ. 심전도 기본 파형 ·········································· 63
* Ⅳ. 비정상 Q파의 기준과 심실성(흥분)시간(VAT) ····· 70

Chapter 5. 정상 심전도 / 75

* Ⅰ. 정상성인 심전도검사에 영향을 미칠 수 있는 요인들 ···· 77
* Ⅱ. 정상성인의 심전도 소견 ································· 78
* Ⅲ. 표준 12유도에서 정상성인의 심전도 소견 ··········· 79
* Ⅳ. 정상소아의 심전도 소견 ································· 83

Chapter 6. 심전도 잡파 / 91

* Ⅰ. 심전도검사 시 교류잡음 잡파(Hum artifact)가 발생하는 원인 ···· 94
* Ⅱ. 심전도검사 시 근전도 잡파(EMG artifact)가 발생하는 원인 ····· 95
* Ⅲ. 심전도검사 시 바닥선 동요 잡파(Drift artifact)가 발생하는 원인 ·· 96
* Ⅳ. 전극이 서로 바뀐 경우 ··································· 97
* Ⅴ. 표준 12유도에서 근전도 잡파의 이해 ················ 99

Chapter 7. 심전도의 검사 및 판독 / 109

* Ⅰ. 심전도검사 시 점검사항 ······························· 111
* Ⅱ. 심전도의 판독 시 기초사항 ··························· 113
* Ⅲ. 심전도(EKG)검사 판독법의 종류 ··················· 113
* Ⅳ. 심장축의 회전 ············································ 123

Chapter 8. 부정맥 / 133

* Ⅰ. 부정맥의 정의 ············································ 135
* Ⅱ. 부정맥(arrhythmia)의 원인 ···························· 136
* Ⅲ. 부정맥(arrhythmia)의 종류 ···························· 137
* Ⅳ. 부정맥 진단 포인트 ······································ 138
* Ⅴ. 정상동조율(normal sinus rhythm, NSR) ··········· 139
* Ⅵ. 동소성(정소성) 부정맥 ·································· 141
* Ⅶ. 이소성 부정맥의 종류 ·································· 148
* Ⅷ. 흥분전도장애 부정맥의 종류 ························· 161
* Ⅸ. 조기흥분 증후군(pre-excitation) 부정맥 ··········· 170

Chapter 9. 비정상 심전도 / 187

* Ⅰ. 관상동맥(심)질환(Coronary insufficiency) ········ 187
* Ⅱ. 심근허혈(Myocardial ischemia) ······················· 188
* Ⅲ. 심근경색(Myocardial infarction) ······················ 189
* Ⅳ. 신방부하(Atrial overload) ······························· 196
* Ⅴ. 심실비대(Ventricular hypertrophy) ·················· 199
* Ⅵ. 우흉심(우심증, Dextrocardia) ························· 205
* Ⅶ. 심막염(심외막염, Pericarditis) ························· 206
* Ⅷ. 급성 심근염(Acute myocarditis) ····················· 207
* Ⅸ. 칼륨($K^+$)혈증에 의한 심전도 변화 ··················· 208
* Ⅹ. 칼슘($Ca^{++}$)혈증에 의한 심전도 변화 ················· 210

Chapter 10. 부하 심전도 / 217

* Ⅰ. 부하 심전도 검사의 목적 ····························· 219
* Ⅱ. 부하의 원리 ··············································· 219
* Ⅲ. 임상적 의의 ··············································· 220
* Ⅳ. 부하 심전도 검사의 종류 ····························· 220
* Ⅴ. 답차 운동부하검사(Treadmill exercise test=TMT) ··· 222

Chapter 11. 24시간 심전도 / 231

* Ⅰ. 검사의 정의 및 원리 ··································· 233
* Ⅱ. 임상적의의 및 목적 ····································· 233
* Ⅲ. 전극의 부착방법 ·········································· 233
* Ⅳ. 검사에 필요한 장비(기기)의 구성 ··················· 234
* Ⅴ. 검사방법 ··················································· 235
* Ⅵ. 환자 숙지사항 ············································ 235