©ç CVA(Cardiovascular accident:½ÉÇ÷°ü¹ßÀÛ) ½Ã±â:91³â
©è HTN ½Ã±â:01³â
©é *C3VD(Coronary3 vessel disease) ½Ã±â:08³â12¿ù
©ê AMI(Acute acute myocardial infarction) ½Ã±â: 08³â
©ë Sick sinus syndrome ½Ã±â:11³â 7¿ù
EKG»ó STEMI(ST segment Elevation Myocardial Infarction STºÐÀý »ó½Â ½É±Ù°æ»öÁõ)´Â ¾Æ´Ï³ª HR 45, RBBB¼Ò°ß ÀÖ¾î NSTEMI ÀǽɵȴÙ. ±â·ÏÁö¿£ ÀÌ·¸°Ô ¾²¼Ì´õ¶ó°í¿ä
Sick sinus syndrome¹× Bradycardia·Î º´¿ø¿¡ À̹ø¿¡ ÀÔ¿øÇÏ°Ô µÇ¼Ë¾î¿ä
ÇҾƹöÁö °Ë»ç°á°ú¸¦ ºÃ´Âµ¥ °Ë»ç°á°ú¸¦ ´ëü ¹«½¼³»¿ëÀÎÁö Çϳªµµ ¸ð¸£°Ú¾î¿ä
ÇҾƹöÁö²²¼ ¼³¸íÇØ´Þ¶ó°í ÇϽŴÀµ¥ Á¤¸» ¾î¶»°Ô ¼³¸íÇصå·Á¾ßÇÒÁö ¸·¸·ÇØ¿ä
|
|
°Ë»ç¸í |
Âü°íÄ¡ |
10.9 |
10.10 |
10.12 |
10.13 |
HL |
|
|
Total protein |
6.0~8.0 |
6.3 |
|
|
|
|
|
|
Albumin |
3.3~5.2 |
3.6 |
|
|
|
|
|
|
glucose |
60~108 |
149 |
|
|
|
¡ã |
|
|
BUN |
8~20 |
24.0¡ã |
26.2¡ã |
14.9 |
16.9 |
|
|
|
Creatinine |
0.6~1.3 |
|
1.4 |
1.1 |
1.1 |
|
|
|
Total bilirubin |
0.2~1.2 |
0.42 |
|
|
|
|
|
|
AST(SGOT) |
5~40 |
25 |
|
|
|
|
|
|
ALT(SGPT) |
0~40 |
18 |
|
|
|
|
|
|
ALP |
44~119 |
68 |
|
|
|
|
|
|
Lactate Dehydronase |
219~480 |
420 |
|
|
|
|
|
|
Uric acid |
4.0~7.0 |
6.2 |
|
|
|
|
|
|
Total cholesterol |
90~200 |
149 |
|
|
|
|
|
|
P(Phosphorus) |
2.5~4.5 |
3.4 |
3.1 |
|
|
|
|
|
Ca(total calcium) |
8.3~10.0 |
7.6 |
7.9¡å |
|
|
|
|
|
A/G ratio |
1.3~0.19 |
1.3 |
|
|
|
|
|
|
Ck(creatinine kinase) |
|
202 |
239 |
|
|
|
|
|
RBC count |
4.5~6 |
4.2 |
3.9 |
3.9 |
3.8 |
¡å |
|
|
MCV |
81~96 |
87.0 |
87.3 |
|
|
|
|
|
Hb |
13~17 |
12.5 |
|
11.3 |
11.0 |
¡å |
|
|
Hct |
36~52 |
36.9 |
33.7 |
33.7 |
32.7 |
|
|
|
PLT |
150~450 |
204 |
211 |
197 |
188 |
|
|
|
MPV |
7.4~10.4 |
9.4 |
9.7 |
9.9 |
|
|
|
|
MCH |
27~33 |
|
29.3 |
28.9 |
29.1 |
|
|
|
MCHC |
32~37 |
|
33.5 |
33.5 |
33.6 |
|
|
|
MCV |
81~96 |
|
|
86.2 |
86.5 |
|
|
|
PDW |
10~18 |
10.0 |
10.7 |
9.7 |
11.7 |
|
|
|
WBC count |
4~10 |
13.35 |
9.29 |
9.62 |
9.27 |
¡ã |
|
|
RDW |
11.5~14.5 |
15.1 |
15.2 |
14.7 |
14.8 |
¡ã |
|
ÀÀ°í |
PT |
70~130 |
89% |
88% |
|
|
|
|
|
PT-sec |
9.5~13.5sec |
12.0 |
12.1 |
|
|
|
|
|
PT-INR |
0.85~1.25 |
1.06 |
1.07 |
|
|
|
|
|
P-LCR |
15~32 |
|
19.6 |
|
23.3 |
|
|
|
PCT |
0.15~0.42 |
|
0.2 |
|
0.2 |
|
|
|
APTT |
23~35 |
23.9 |
25.1 |
|
|
|
|
|
K(potassium) |
3.5~5.5 |
4.8 |
4.1 |
3.9 |
3.7 |
|
|
|
Cl(chloride) |
98~110 |
107 |
109 |
109 |
110 |
|
|
|
Na |
135~145 |
|
143 |
143 |
145 |
|
|
|
Mg |
1.5~2.5 |
|
2.5 |
|
|
|
|
|
CK-MB |
0.1~5.8 |
|
8.2¡ã |
5.7 |
4.6 |
|
|
|
Troponin I |
0.00~0.16 |
0.32 |
2.23¡ã |
1.17 |
0.92 |
¡ã |
|
|
BNP |
0~100 |
234 |
|
|
|
¡ã |
|
|
Total CO2 |
22~29 |
|
22 |
22 |
23 |
|
|
differential count |
Lym |
|
|
|
|
25.5 |
|
|
|
Mono |
2~10 |
|
|
|
10.8 |
|
|
|
Neu |
|
|
|
|
62.6 |
|
|
|
EO |
1~5% |
|
|
|
0.9 |
|
|
|
Ba |
0~2 |
|
|
|
0.2 |
¡å |
À̹ø¿¡ pacemaker¸¦ ´Ù¼Ë¾î¿ä (12ÀÏ)
11.10.10 Echocardiography °á°úÁö
¨çNo regional wall motion abnormality
¨èconcentric LVH With normal LV systolic function
¨éRelaxation abnormality of LV filling pattern
¨êelevated E/E = 19.3
¨ëMild AR(GRII) d/f degenerative change
¨ìBorderline enlarged LV Filling pattern.
11.10.10 °ü»óµ¿¸Æ Á¶¿µ¼ú ¹× ÁßÀç¼ú
•1 vessel disease
•Native vessels diseased (LCX)
•1st OM patent previous stent
•Access site radial right
•Coronary artery segment[±×¸²!!!]
ECG Reading
Marked sinus bradycardia with marked sinus arrhythmia
Right bundle branch block
Lt ventricular hypertrophy with QRS widening and repolarization abnormality
ST elevation consider inferior injury or acute infarction.
***Acute MI
Abnormal ECG (2011.10.9)
ventricular rate 47 bpm
PR interval 192 ms
QRS Duration 156 ms
QT/QTC 534/472 ms
P-R-T axes 47-42-28
ÀÎÅÏÀÌ ¸ð¶ó°í ¼³¸íÇÞ±ä Ç޴µ¥ Àü ÀüÇô °¨À» ¸øÀâ°Ú¾î¿ä ½±°Ô ¼³¸íÇØÁÖÁöµµ ¾Ê°í STºÐÀýÀÌ ¹ºÁö Àü Àß ¸ð¸£°Ú°Åµç¿ä
ÀÇ·áÂÊ Àü°øÀ̶ó ÇҾƹöÁö ¾ÆÇÁ½Åµ¥ ÇҾƹöÁö²² µµ¿òÀÌ µÇ°í½Í¾î¿ä
Á¦°¡ ÀÇ·á°èÂÊÀ¸·Î ³ª°¡·Á´Â°Íµµ ÇҾƹöÁö°¡ ¿À·§µ¿¾È ¸¹ÀÌ ÆíÂúÀ¸¼Ì±â ¶§¹®¿¡ Á¦°¡ ÀÇ·á°è·Î °¥·Á°í Çϴ°ſ¡¿ä
¾ÆÁ÷ ÀÏÇгâÀ̶ó °ü½ÉÀº ¸¹Áö¸¸ ¾Æ´Â°Ç ¸¹Áö ¾Ê³×¿ä ±×³É °Ë»öÀ¸·Î ¤Ð¤Ð
À̹ø¿¡ ÀÔ¿ø ÇØ °è½Ç¶§µµ ÃÆ® ÀϺη¯ ´õ º¸¿©´Þ¶ó°í ÇÞ¾î¿ä
°øºÎ ¸¹ÀÌ Çؼ ÇҾƹöÁö Æí¾ÈÇÏ°Ô Çص帮·Á°í¿ä
¤Ð¤Ð..±Ùµ¥ Àú ÀÌ°Å ¸øÀÐ¾î¼ ³ªÁß¿¡ ÀÇ·áÀÎÀÌ µÉ¼ö ÀÕÀ»Áö ¸ð¸£°Ù¾î¿ä
|
|
°Ë»ç¸í |
Âü°íÄ¡ |
10.9 |
10.10 |
10.12 |
10.13 |
HL |
|
°¨¿°¿©ºÎ |
Total protein |
6.0~8.0 |
6.3 |
|
|
|
|
|
|
Albumin |
3.3~5.2 |
3.6 |
|
|
|
|
|
|
glucose |
60~108 |
149 |
|
|
|
¡ã |
|
|
BUN |
8~20 |
24.0¡ã |
26.2¡ã |
14.9 |
16.9 |
|
|
|
Creatinine |
0.6~1.3 |
|
1.4 |
1.1 |
1.1 |
|
|
|
Total bilirubin |
0.2~1.2 |
0.42 |
|
|
|
|
|
|
AST(SGOT) |
5~40 |
25 |
|
|
|
|
|
|
ALT(SGPT) |
0~40 |
18 |
|
|
|
|
|
|
ALP |
44~119 |
68 |
|
|
|
|
|
|
Lactate Dehydronase |
219~480 |
420 |
|
|
|
|
|
|
Uric acid |
4.0~7.0 |
6.2 |
|
|
|
|
|
|
Total cholesterol |
90~200 |
149 |
|
|
|
|
|
|
P(Phosphorus) |
2.5~4.5 |
3.4 |
3.1 |
|
|
|
|
|
Ca(total calcium) |
8.3~10.0 |
7.6 |
7.9¡å |
|
|
|
|
|
A/G ratio |
1.3~0.19 |
1.3 |
|
|
|
|
|
|
Ck(creatinine kinase) |
|
202 |
239 |
|
|
|
|
ºóÇ÷°Ë»ç |
RBC count |
4.5~6 |
4.2 |
3.9 |
3.9 |
3.8 |
¡å |
|
|
MCV |
81~96 |
87.0 |
87.3 |
|
|
|
|
|
Hb |
13~17 |
12.5 |
|
11.3 |
11.0 |
¡å |
|
|
Hct |
36~52 |
36.9 |
33.7 |
33.7 |
32.7 |
|
|
|
PLT |
150~450 |
204 |
211 |
197 |
188 |
|
|
|
MPV |
7.4~10.4 |
9.4 |
9.7 |
9.9 |
|
|
|
|
MCH |
27~33 |
|
29.3 |
28.9 |
29.1 |
|
|
|
MCHC |
32~37 |
|
33.5 |
33.5 |
33.6 |
|
|
|
MCV |
81~96 |
|
|
86.2 |
86.5 |
|
|
|
PDW |
10~18 |
10.0 |
10.7 |
9.7 |
11.7 |
|
|
|
WBC count |
4~10 |
13.35 |
9.29 |
9.62 |
9.27 |
¡ã |
|
|
RDW |
11.5~14.5 |
15.1 |
15.2 |
14.7 |
14.8 |
¡ã |
|
ÀÀ°í |
PT |
70~130 |
89% |
88% |
|
|
|
|
|
PT-sec |
9.5~13.5sec |
12.0 |
12.1 |
|
|
|
|
|
PT-INR |
0.85~1.25 |
1.06 |
1.07 |
|
|
|
|
|
P-LCR |
15~32 |
|
19.6 |
|
23.3 |
|
|
|
PCT |
0.15~0.42 |
|
0.2 |
|
0.2 |
|
|
|
APTT |
23~35 |
23.9 |
25.1 |
|
|
|
|
|
K(potassium) |
3.5~5.5 |
4.8 |
4.1 |
3.9 |
3.7 |
|
|
|
Cl(chloride) |
98~110 |
107 |
109 |
109 |
110 |
|
|
|
Na |
135~145 |
|
143 |
143 |
145 |
|
|
|
Mg |
1.5~2.5 |
|
2.5 |
|
|
|
|
|
CK-MB |
0.1~5.8 |
|
8.2¡ã |
5.7 |
4.6 |
|
|
|
Troponin I |
0.00~0.16 |
0.32 |
2.23¡ã |
1.17 |
0.92 |
¡ã |
|
|
BNP |
0~100 |
234 |
|
|
|
¡ã |
|
|
Total CO2 |
22~29 |
|
22 |
22 |
23 |
|
|
differential count |
Lym |
|
|
|
|
25.5 |
|
|
|
Mono |
2~10 |
|
|
|
10.8 |
|
|
|
Neu |
|
|
|
|
62.6 |
|
|
|
EO |
1~5% |
|
|
|
0.9 |
|
|
|
Ba |
0~2 |
|
|
|
0.2 |
¡å |
Á¦°¡ ³ª¸§´ë·Î °Ë»öÇغ¸°í ã¾Æº» °á°ú »¡°£»öÀ¸·Î Ç¥½ÃµÈ ºÎºÐÀÌ ¾à°£ÀÇ ºñÁ¤»óÀÌ ³ª¿Â°Å´õ¶ó°í¿ä
¿ò Æ®·ÎÆ÷´ÑÀ̶û ck-mb°¡ »ó½ÂµÈ°É·Î ºÁ¼ ½É±ÙÀÌ ¼Õ»óµÇ¾ú´Ù ±×Á¤µµ´Â ¾Ë¼ö ÀÕ°í
RBC Hb ¼öÄ¡ ºÁ¼ ¾à°£ÀÇ ºóÇ÷±â°¡ ÀÖÀ¸½Å°Í °°Àºµ¥ ÀÌ°Ç ¿°Áõ¹ÝÀÀÀ¸·Î º¼¼öÀÖ´Ù°í µé¾ú¾î¿ä
EKG±×·¡ÇÁ´Â ºÁµµºÁµµ ¾î·Æ³×¿ä ¾îÄÉ Àоî¾ßµÇ´Â°É±î¿ä ±×³É ±×¸²À¸·Î ¿Ü¿ö¾ßµÇ´Â°É±î¿ä?