Elektrokardiyografi‘de Sık Atlanan Bulgular

Öz

Elektrokardiyografi (EKG), acil servislerde tanısal bir temel taşı olmasına rağmen hatalı yorumlanmaya oldukça açıktır. Zaman baskısı ve otomatik yorumlara duyulan aşırı güven, özellikle klasik STEMI kriterlerini karşılamayan ancak yüksek mortalite riski taşıyan durumların atlanmasına neden olabilir. Bu metinde; sistematik bir değerlendirme sırası (ritim, hız, aks, intervaller, ST-T ve QRS morfolojisi) önerilmektedir. Ayrıca; sinüs taşikardisinin patolojik nedenleri, aks sapmalarının klinik önemi, atriyal genişlemeler (P mitrale/pulmonale), PR mesafesi anomalileri (WPW, AV bloklar), QRS voltaj değişiklikleri (tamponat) ve hayati önem taşıyan ST-T değişiklikleri (Posterior MI, De Winter, Brugada, Wellens Sendromu) ele alınmaktadır. Klinik korelasyonun önemi vurgulanarak, elektrot hataları gibi yanıltıcı faktörlere karşı dikkatli olunması gerektiği belirtilmektedir.

Anahtar Kelimeler

• EKG
• Acil Tıp
• Wellens Sendromu
• WPW
• Brugada Sendromu

Frequently Missed Findings in Electrocardiography

Öz

Although electrocardiography (ECG) is a diagnostic cornerstone in emergency departments, it is highly prone to misinterpretation. Time pressure and over-reliance on automated ECG interpretations can lead to overlooking conditions that do not meet classic STEMI criteria but carry a high risk of mortality. This text suggests a systematic evaluation sequence (rhythm, rate, axis, intervals, ST-T, and QRS morphology). Furthermore, it addresses pathological causes of sinus tachycardia, clinical significance of axis deviations, atrial enlargements (P mitrale/pulmonale), PR interval anomalies (WPW, AV blocks), QRS voltage changes (tamponade), and life-threatening ST-T changes (Posterior MI, De Winter, Brugada, and Wellens Syndrome). Emphasizing the importance of clinical correlation, it highlights the need for vigilance against misleading factors such as electrode misplacements.

Anahtar Kelimeler

• ECG
• Emergency Medicine
• Wellens Syndrome
• WPW
• Brugada Syndrome

Kaynakça

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