Bisteni Adem Abdo
Depto de Electrofisiología, Instituto Nacional de Cardiología Ignacio Chávez, INCICH, Juan Badiano No. 1 Col. Sección XVI, Tlalpan 14080 México, D.F.
Arch Cardiol Mex. 2004 Jan-Mar;74 Suppl 1:S32-7.
The diagnosis of myocardial ischemia is not confine to the alteration of the RS-T segment and of the T wave. Conduction disorders at any level can be caused by the ischemia itself and contribute to the diagnosis, as well as the ventricular arrhythmias. On the other hand, conduction blocks do not hinder or hide the diagnosis of ischemia. The primary and secondary characteristics of the T wave and RS-T segment are discussed. The relevance of the knowledge of ventricular activation vectors in bundle branch blocks is shown, as well as their alteration in case of associated myocardial infarction. Emphasis is made on the importance of the deductive method in the electrocardiographic interpretation.
心肌缺血的诊断并不局限于RS-T段和T波的改变。缺血本身可导致任何水平的传导障碍,这有助于诊断,室性心律失常也是如此。另一方面,传导阻滞并不妨碍或掩盖缺血的诊断。文中讨论了T波和RS-T段的原发性和继发性特征。阐述了束支阻滞时心室激动向量知识的相关性,以及合并心肌梗死时这些向量的改变。强调了演绎法在心电图解读中的重要性。