Yahalom Malka, Gellerman Marc, Wishniak Alice, Brezins Marc, Roguin Nathan
Cardiology Department and Heart Institute, Western Galilee Hospital, Nahariya, Israel.
Harefuah. 2003 Jan;142(1):2-4, 80.
The electrocardiogram (ECG) is of critical importance in the diagnosis of acute myocardial infarction. Clinical conditions such as acute pericarditis, esophageal rupture, pancreatitis, subarachnoid hemorrhage, perforated duodenal ulcer, pneumothorax and status following elective DC cardioversion result in ECG changes that include ST elevation and T wave inversion. This report aims to increase the awareness of non-cardiac syndromes, with ECG abnormalities mimicking acute myocardial infarction, and thus to avoid unjustified thrombolytic therapy. We describe the case of a patient after epileptic seizures and pathological EEG pattern. The ECG showed repolarization abnormalities suggestive of evolving acute myocardial infarction. The cardiac enzymes (except normal Troponin I) were severely elevated and coronary angiography was normal.
心电图（ECG）在急性心肌梗死的诊断中至关重要。急性心包炎、食管破裂、胰腺炎、蛛网膜下腔出血、十二指肠溃疡穿孔、气胸以及择期直流电复律后的状态等临床情况会导致心电图改变，包括ST段抬高和T波倒置。本报告旨在提高对非心脏综合征的认识，这些综合征的心电图异常酷似急性心肌梗死，从而避免不合理的溶栓治疗。我们描述了一例癫痫发作后及脑电图异常的患者病例。心电图显示复极异常，提示急性心肌梗死进展。心脏酶（除肌钙蛋白I正常外）显著升高，冠状动脉造影正常。
