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加压单极肢体导联V（右上肢）导联的ST段抬高也可能由无固定狭窄的弥漫性左主干冠状动脉痉挛引起。

ST-segment elevation in lead augmented vector right may also be caused by diffuse left main coronary artery vasospasm without fixed stenosis.

作者信息

Duygu Hamza, Yavuzgil Oguz, Erturk Umit, Zoghi Mehdi, Ozerkan Filiz

机构信息

Department of Cardiology, Ege University, Izmir, Turkey.

出版信息

Clin Cardiol. 2008 Apr;31(4):179-82. doi: 10.1002/clc.20166.

DOI:10.1002/clc.20166
PMID:18404728
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6653292/
Abstract

ST-segment deviation in lead augmented vector right (aVR) is useful for evaluating patients with acute coronary syndrome (ACS). The ST-segment elevation in this aVR in the patient with clinically suspected acute coronary syndrome suggests a strong possibility of left main coronary artery (LMCA) obstruction due to fixed stenosis. In this article, we report the first case, to our knowledge, of ST-segment elevation in lead aVR due to diffuse LMCA spasm.

摘要

右上肢加压单极肢体导联（aVR）中的ST段偏移有助于评估急性冠状动脉综合征（ACS）患者。临床怀疑为急性冠状动脉综合征的患者，其aVR导联ST段抬高提示因固定性狭窄导致左主干冠状动脉（LMCA）阻塞的可能性很大。据我们所知，本文报告了首例因弥漫性LMCA痉挛导致aVR导联ST段抬高的病例。

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本文引用的文献

1
Clinical features of emergency electrocardiography in patients with acute myocardial infarction caused by left main trunk obstruction.左主干闭塞所致急性心肌梗死患者急诊心电图的临床特征
Circ J. 2006 May;70(5):525-9. doi: 10.1253/circj.70.525.
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Combined prognostic utility of ST segment in lead aVR and troponin T on admission in non-ST-segment elevation acute coronary syndromes.aVR导联ST段与入院时肌钙蛋白T联合应用对非ST段抬高型急性冠脉综合征的预后评估价值
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Prognostic value of lead aVR in patients with a first non-ST-segment elevation acute myocardial infarction.aVR导联对首次非ST段抬高型急性心肌梗死患者的预后价值
Circulation. 2003 Aug 19;108(7):814-9. doi: 10.1161/01.CIR.0000084553.92734.83. Epub 2003 Jul 28.
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The disappearing coronary stenosis: reemphasizing the importance of excluding coronary vasospasm before coronary intervention.消失的冠状动脉狭窄：再次强调冠状动脉介入治疗前排除冠状动脉痉挛的重要性。
Catheter Cardiovasc Interv. 2002 Oct;57(2):224-8. doi: 10.1002/ccd.10331.
8
ACC/AHA guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction--2002: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Unstable Angina).美国心脏病学会/美国心脏协会不稳定型心绞痛和非ST段抬高型心肌梗死患者管理指南更新——2002：总结篇：美国心脏病学会/美国心脏协会实践指南工作组（不稳定型心绞痛患者管理委员会）报告
Circulation. 2002 Oct 1;106(14):1893-900. doi: 10.1161/01.cir.0000037106.76139.53.
9
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Severe, resistant spasm of the left main coronary artery--a serious pitfall.左冠状动脉主干严重、顽固性痉挛——一个严重的陷阱。
J Invasive Cardiol. 2000 Jun;12(6):327-9.