Goyal Manju, Woods Kevin M, Atwood John E
Cardiology Service, Carl R. Darnall Army Medical Center, Fort Hood, TX 76544, USA.
South Med J. 2013 Aug;106(8):485-9. doi: 10.1097/SMJ.0b013e3182a1456c.
Electrical alternans is an electrocardiographic phenomenon defined as an alternating amplitude or axis of the QRS complexes in any or all leads. It is most commonly associated with a large pericardial effusion and impending threat of cardiac tamponade; however, a literature review showed that this electrocardiographic finding can be seen in a variety of other clinical scenarios with varying etiologies and prognoses. Several electrocardiogram examples are presented with a brief review of the potential mechanisms and clinical significance and demonstrate that electrical alternans is more correctly considered an electrocardiographic sign, rather than a diagnosis, with a broad differential for potential etiologies. For some causes, the clinical significance is well known, but for others, further research is needed.
电交替是一种心电图现象，定义为任何导联或所有导联中QRS波群的振幅或电轴交替变化。它最常与大量心包积液和即将发生的心包填塞威胁相关；然而，一项文献综述表明，这种心电图表现可见于多种其他临床情况，病因和预后各不相同。本文展示了几个心电图实例，并简要回顾了潜在机制和临床意义，证明电交替更应被视为一种心电图征象，而非诊断，其潜在病因的鉴别诊断范围广泛。对于某些病因，其临床意义已为人熟知，但对于其他病因，则需要进一步研究。
