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J 波出现后弥漫性 ST 段抬高,作为 Takotsubo 心肌病一种不常见的心电图模式。

Diffuse ST-elevation following J-wave presentation as an uncommon electrocardiogram pattern of Tako-Tsubo cardiomyopathy.

机构信息

Department of Cardiology, University of Foggia, Foggia, Italy.

出版信息

Heart Lung. 2013 Sep-Oct;42(5):375-8. doi: 10.1016/j.hrtlng.2013.05.002. Epub 2013 Jun 27.

Abstract

BACKGROUND

Tako-Tsubo cardiomyopathy (TTC) is characterized by symptoms, ECG changes with elevated cardiac markers mimicking acute myocardial infarction, left ventricular (LV) wall motion abnormalities in the apical region with preserved function of base, and normal coronary arteries. Usual ECG anomalies heralding TTC are ST-elevation in anterior leads, QT prolongation and negative T-waves.

METHODS

We report the unusual case of TTC with an uncommon ECG presentation: J wave in inferior leads followed by diffuse ST-elevation.

RESULTS

An 82-year-old woman was admitted for dyspnea and chest pain following exacerbation of chronic obstructive pulmonary disease. ECG showed J-wave in inferior leads followed by diffuse ST-elevation. The patient was monitored in intensive care unit and treated with diuretics. Both ECG and echocardiography anomalies gradually recovered.

CONCLUSIONS

Diffuse ST-elevation following J-waves may be considered as a possible ECG pattern of presentation in case of TTC.

摘要

背景

心肌应变综合征(Tako-Tsubo 心肌病,TTC)的特征为出现类似急性心肌梗死的症状、心电图改变和升高的心脏标志物,左心室(LV)心尖区域壁运动异常伴基底段功能正常,且冠状动脉正常。预示 TTC 的常见心电图异常为前导导联 ST 段抬高、QT 间期延长和负 T 波。

方法

我们报告了 TTC 的不常见心电图表现的罕见病例:下导导联 J 波,随后出现弥漫性 ST 段抬高。

结果

一名 82 岁女性因慢性阻塞性肺病恶化出现呼吸困难和胸痛而入院。心电图显示下导导联 J 波,随后出现弥漫性 ST 段抬高。患者在重症监护病房接受监测并接受利尿剂治疗。心电图和超声心动图异常逐渐恢复。

结论

J 波后弥漫性 ST 段抬高可被视为 TTC 情况下可能出现的心电图表现模式。

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