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[紧急心脏复律后ST段变化解读中的问题]

[Problems in the interpretation of changes in the ST segment after emergency cardioversion].

作者信息

García Robles J A, Pérez Pandelo R, Almazán Ceballos A, Pastor Fuentes A, Muñoz Aguilera R

机构信息

Servicio de Cardiología, Hospital General Gregorio Marañón, Madrid.

出版信息

Rev Clin Esp. 1991 Nov;189(8):377-8.

PMID:1784801
Abstract

After cardioversion with continuous current (CV) we can find alterations in the ST segment and T wave, frequently associated with an increase in CPK total and CPKmB, which can lead us to the wrong diagnosis of acute myocardial infarction (AMI). We describe five cases of transitory alterations in ST after CV: four regular tachycardias with wide QRS and an atrial fibrillation with fast ventricular response. CPK, CPKmB and ECG were monitored being the CPK abnormal in all cases. AMI was discarded in all cases. When changes in ST following CV are observed, we believe that AMI should be discarded by ECG and enzymatic monitorization. If doubts persist technetium-99mm pyrophosphate must be used.

摘要

在采用直流电复律(CV)后,我们可发现ST段和T波改变,常伴有总肌酸磷酸激酶(CPK)及肌酸磷酸激酶同工酶(CPKmB)升高,这可能会导致我们对急性心肌梗死(AMI)做出错误诊断。我们描述了5例复律后ST段短暂改变的病例:4例为宽QRS波的规则性心动过速及1例伴有快速心室反应的心房颤动。对所有病例均监测了CPK、CPKmB及心电图,结果所有病例CPK均异常。所有病例均排除了AMI。当观察到复律后ST段改变时,我们认为应通过心电图及酶学监测排除AMI。若仍存疑问,则必须使用99锝焦磷酸盐。

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