患者男性,44岁,胸痛胸闷3小时余急诊就诊,记录常规心电图如下。
心电图特征:
心电图解析:
I级缺血表现为高耸T波(图2A);
Ⅱ级缺血表现为 ST 段抬高伴T波高耸(图2B);
Ⅲ级缺血是在Ⅱ级缺血的基础上出现QRS波终末变形 【1】。
V1-3等S波为主的导联,S波消失(图2D)。
其它R波为主的导联,J点抬高≧50%的R波(图2C)。
--------------------------------------
作者简介:
参考文献:
【1】Sclarovskys, Strasberg B, Lewin RF, et al.Effects of isosorbide dinitrates intravenously in high doses over a short period in anterior acute myocardial infarction.Am J Cardiol, 1988.61(9):78E-80E
【2】BirnbaumY, Kloner RA, Sclarovsky s, et al.Distortion of the terminal portion of the QRs on the admission electrocardiogram in acute myocardial infarction and correlation with infarct size and long-term prognosis(Thrombolysis in Myocardial Infarction 4 Trial).Am J Cardiol1996.78(4):396-403.
【3】Tamura A, Nagase K, Watanabe T,et al.Relationship between terminal QRS distortion on the admission electrocardiogram and the time course of left ventricular wall motion in anterior wall acute myocardial infarction. Jpn Circ J.2001,65(2):63-66.
【4】Holland RP, Brooks H.The QRS complex during myocardial ischemia. An experimental analysis in the porcine heart.J Clin Invest, 1976,57(3):541-550.。
【5】Prasitlumkum N, Sirinvaravong N, Limpruttidham N, Rattanawong P, Tom E, Kanitsoraphan C, Chongsathidkiet P, Boondarikpornpant T. Terminal QRS Distortion in ST Elevation Myocardial Infarction as a Prediction of Mortality: Systematic Review and Meta-Analysis. Acta Cardiol Sin. 2019 Sep;35(5):445-458. doi: 10.6515/ACS.201909_35(5).20180909A. PMID: 31571793; PMCID: PMC6760130.
联系客服