Kehl K
Institut für klinische Ultraschalldiagnostik, Klinikums Berlin-Buch.
Z Gesamte Inn Med. 1990 Dec 15;45(24):741-3.
63 patients with clearly defined myocardial infarction and an echocardiographically evident akinesia and hypokinesia, respectively, were examined by means of the echocardiography, the conventional ECG (12 leads) and the classical mapping ECG (69 leads). From the latter a mini-mapping ECG (12 chest electrodes) was led. IN 20% of the cases we did not find an accordance between the classical mapping ECG and the mini-mapping ECG in the localization of an echocardiographically proved disturbance of the excursion of the heart wall. In these cases small circumscribed myocardial lesions were concerned which were located particularly postero-inferiorly, the proof of which restricted itself to a thoracic surface less than 54-108 cm2 in the classical mapping ECG. But in larger lesions of the myocardium already the conventional ECG shows correct diagnostic statements. The coordination of the myocardial infarctions to the individual parts of the heart can be performed on the basis of a topographic mapping ECG card. A quantitative estimation of the electrocardiographic findings is not possible with the mini-mapping-ECG. The diagnostic valency of the mini-mapping-ECG is to be arranged only in the third place after the classical mapping ECG and the conventional ECG!
对63例明确诊断为心肌梗死且分别经超声心动图证实有运动不能和运动减弱的患者,进行了超声心动图、常规心电图(12导联)和经典标测心电图(69导联)检查。从后者导出了一个微型标测心电图(12个胸电极)。在20%的病例中,我们发现在超声心动图证实的心肌壁运动障碍定位方面,经典标测心电图与微型标测心电图不一致。在这些病例中,涉及的是小范围的局限性心肌病变,特别是位于后下部位,在经典标测心电图中其证据局限于胸壁面积小于54 - 108平方厘米。但在较大的心肌病变中,常规心电图已能做出正确的诊断陈述。心肌梗死与心脏各个部位的对应关系可根据一张地形图式标测心电图来确定。微型标测心电图无法对心电图结果进行定量评估。微型标测心电图的诊断价值仅排在经典标测心电图和常规心电图之后的第三位!