Cooksey J, Parker B M, Aker U, Bahl O P
South Med J. 1976 Jul;69(7):864-7. doi: 10.1097/00007611-197607000-00018.
The clinical, hemodynamic, and electrocardiographic findings in 11 patients with mitral regurgitation secondary to ruptured chordae tendineae are presented. Left atrial overloading, as manifested by a large terminal negative force in the P wave of lead V1, was present in 8 of the 11 patients. Six of the eight patients with this atrial abnormality had a normal size or minimally enlarged left atrium on chest x-ray films and angiography. Left ventricular hypertrohpy was present in 7 of the 11 patients and appeared to be related to the duration of cardiac symptoms. It is concluded that a large terminal negative force in the P wave in lead V1 is a useful clinical indicator of increased left atrial pressure in mitral regurgitation of recent onset. The electrocardiographic finding of left atrial overloading is to be expected in most cases of mitral regurgitation secondary to rupture of the chordae tendineae.
本文报告了11例因腱索断裂继发二尖瓣反流患者的临床、血流动力学及心电图表现。11例患者中有8例出现左心房负荷过重，表现为V1导联P波终末负向波增大。这8例心房异常患者中，有6例胸部X线片和血管造影显示左心房大小正常或轻度增大。11例患者中有7例出现左心室肥厚，且似乎与心脏症状持续时间有关。结论是，V1导联P波终末负向波增大是近期发生的二尖瓣反流中左心房压力升高的有用临床指标。在大多数因腱索断裂继发二尖瓣反流的病例中，预计会出现左心房负荷过重的心电图表现。
