NHP NHANH TREN THAT

(SUPRAVENTRICULAR TACHYCARDIA)

BS. CuTy-Angiang

Bao gom : - Nhp nhanh xoang - Nhp nhanh nh - Nhp nhanh bo noi - Cuong nh - Rung nh C che : - O t ong gia toc (Accelerated automaticity) - Vao lai(re-entry). ieu kien:
Co vong thch hp ap ng dan truyen khac nhau 2 ben vong S dan truyen u cham e nhanh kia co u thi gian hoi phuc

10/22/2013

10/22/2013

ac iem chung:
1. Phc hp QRS bnh thng Tan so 100 200 l/p 2. Song P co dang bat thng nhng luon co moi tng quan vi QRS 3. Thng co ST _ T ao
10/22/2013

1.

I.

Nhp nhanh xoang (Sinus tachycardia)

O T ONG GIA TOC

10/22/2013

QRS bnh thng PR ngan hn bnh thng Tan so : 100 200 l/p

2. a)

Nhp nhanh nh (atrial tachyarrhythmias)

Nhp nh gia toc (accelerated atrial rhythm)

QRS bnh thng, tan so : 60 130 l/p P hnh dang khac P bnh thng PR bnh thng hoac ngan hn Bat au va cham dt ot ngot i kem vi block A V

b) c)

Nhp nhanh nh kch phat vi block

Nhp nhanh nh kch a o (multifocal atrial tachycadia)

Song P nhieu hnh dang Nhp hoan toan khong eu PP PR RR eu thay oi Thng i kem block A V Tan so nh 100 200 Tan so that 100 150 l/p

3.

QRS bnh thng Tan so QRS : 60 130 l/p Khong co song P i trc 10/22/2013

Nhp bo noi gia toc ( accelerate Junctional rhythm)

II. VAO LAI

1.

Nhp nhanh xoang vao lai

QRS bnh thng Bat au va cham dt ot ngot Tan so 100 160 l/p

2.

Nhp nhanh nh kch phat vao lai

P bnh thng vi PR dai bnh thng Thng bat au bang 3 NTT nh lien tuc Nhp eu, PP khong thay oi QRS bnh thng Tan so 140 250 l/p

10/22/2013

3.

a)

Vao lai theo ng phu di canh nut A-V (AV bypass tachycardia) Orthodromic Antidromic b) Vao lai trong nut A-V : Slow fast Fast slow

Nhp nhanh bo noi vao lai

10/22/2013

* Orthodromic AV bypass tachycardia

10/22/2013

QRS bnh thng tan so 170 250 l/p Bat au bang 1 NTT nh RR khi au hi dai hn bnh thng P ngc theo sau QRS

Co song Kch thch phe v lam cham hoac cham dt cn nhp nhanh

* Antidromic AV bypass tachycardia

Co song Kch thch phe v lam cham hoac cham dt 10/22/2013

QRS dan rong , tan so 170 250 l/p Bat au bang 1 NTT nh PR khi au bnh thng P ngc, i trc QRS

* Vong vao lai nut nh that

Cham nhanh
Xay ra PR khi au Thng gap Khi au bang Lien quan P/QRS Tan so
10/22/2013

Nhanh cham
dai dang bnh thng tre em NTT nh hoac that P sau QRS RP>PR 100 150 l/p

kch phat keo dai ngi ln NTT nh P an hoac ngay sau QRS 140 200 l/p

10/22/2013

III CUONG NH (ATRIAL FLUTTER)

Song F :dang rang ca , eu ro nhat II III avF tan so 200 400 l/p, thong thng 300l/p Dan truyen A V : 2:1 4:1 hiem hn : 3:1 5:1 6:1 Phc hp QRS bnh thng Song T co the lam bien dang P
10/22/2013

6: 2

10/22/2013

IV. RUNG NH (ATRIAL FIBRILATION)

Khong thay song P Co the thay song F khong eu QRS bnh thng, RR thay oi, bien o song P thay oi 4 nguyen nhan thng gap nhat cua rung nh 1 Hep van 2 la 2 Benh ong mach vanh 3 Benh tim do CHA 4 Cng giap

10/22/2013

10/22/2013

10/22/2013

H. 1

10/22/2013

H. 2

10/22/2013

H. 3

10/22/2013

H. 4

H. 5
10/22/2013

10/22/2013

H. 6

10/22/2013

H. 7

10/22/2013

H. 8

10/22/2013

H. 9