急診熊心聲部落格An editorial notebook

ECG動畫館

我用程式做的ECG教學短片，一支講一件事，大多一分鐘上下，直式、有中文旁白和字幕。依系列分組，每支附一句重點和參考來源。

OMI系列

OMI圖鑑20個finding，一個finding一支短片。

STDmax V1–V4

indicative of posterior OMI

precordial的STD最深在V1–V4，就要高度懷疑posterior OMI（specificity 97%）

▶ 1:15 OMI圖鑑

參考來源

Baltazar, Basic & Bedside Electrocardiography
Critical Cases in Electrocardiography
Critical Decisions in Emergency and Acute Care Electrocardiography
Grauer, ECG Pocket Brain
Sparkson, Illustrated Guide to ECG 2e
Hanna, Practical Cardiovascular Medicine
Roberts & Hedges' Clinical Procedures
Dr. Smith's ECG Blog
ECG Weekly
LITFL
Meyers HP, et al. J Am Heart Assoc 2021
REBEL EM
AHA/ACCF/HRS 2009 Part VI
Fourth UDMI 2018

Wellens' syndrome

胸痛停了，T wave還在警告

▶ 1:24 OMI圖鑑

參考來源

Mattu, ECG in Emergency, Acute & Critical Care 2e
Sparkson 2e
LITFL

基礎機轉

心電圖的波從哪裡來、ST為什麼會抬高。

高血鉀的特別長相

RAD＋rightward leads STE

看到V1、V2、aVR的ST抬高加上RAD，心中一定要有三個DDx：Hyper-K、PE、Na channel blocker；不要先想AMI

▶ 1:01

參考來源

ECG Weekly 2025-02-10 Inservice/Boards Exam Prep Pt. I（Classic Hyperkalemia）
Mattu, ECG in Emergency, Acute & Critical Care 2e
Mattu & Brady, ECGs for the Emergency Physician 2
Braunwald's Heart Disease
Electrocardiogram in Clinical Medicine
Chou's Electrocardiography 6th
Goldberger's Clinical Electrocardiography 9th
ABC of Clinical Electrocardiography
Rosen's Emergency Medicine 10th
Marriott's Practical Electrocardiography 13th
LITFL
Dr. Smith's ECG Blog

AIVR vs VT

別被搶眼的心室節律吸走

寬QRS別急著電：先看rate，再看病人；STEMI後出現的慢寬QRS可能是AIVR（reperfusion rhythm），別當VT電

▶ 1:16

參考來源

LITFL
Ken Grauer ECG Blog
Dr. Smith's ECG Blog
ECG Weekly (Mattu)
Braunwald's Heart Disease
Tintinalli's Emergency Medicine
AHA 2025 Adult ALS (Circulation 2025;152:S538)
心臟模型改作自BodyParts3D, © DBCLS, CC BY 4.0