V1 - V2导联中rSr'图形的鉴别诊断。全面综述及提出的算法。
Differential diagnosis of rSr' pattern in leads V1 -V2. Comprehensive review and proposed algorithm.
作者信息
Baranchuk Adrian, Enriquez Andres, García-Niebla Javier, Bayés-Genís Antoni, Villuendas Roger, Bayés de Luna Antoni
机构信息
Division of Cardiology, Queen's University, Kingston, Ontario, Canada.
出版信息
Ann Noninvasive Electrocardiol. 2015 Jan;20(1):7-17. doi: 10.1111/anec.12241. Epub 2014 Dec 26.
Abstract
One of the more frequent dilemmas in ECG interpretation is the differential diagnosis of an rSr' pattern in leads V1 -V2 . We often face this finding in asymptomatic and otherwise healthy individuals and the causes may vary from benign nonpathological variants to severe or life-threatening heart diseases, such as Brugada syndrome or arrhythmogenic right ventricular dysplasia. In other cases, a normal variant of rSr' pattern can be misinterpreted as pathological after the occurrence of certain clinical events such as cardiac arrest or syncope of unknown cause. In this review we analyze in detail all the possible conditions, both benign and pathological that may explain the presence of this electrocardiographic pattern. We also propose a simple electrocardiographic algorithm for differential diagnosis.
摘要
心电图解读中较常见的难题之一是鉴别V1 - V2导联出现的rSr'图形。我们常在无症状且其他方面健康的个体中发现这一表现，其原因可能从良性非病理性变异到严重或危及生命的心脏病不等，如Brugada综合征或致心律失常性右室发育不良。在其他情况下，rSr'图形的正常变异在发生某些临床事件（如心脏骤停或不明原因的晕厥）后可能被误诊为病理性的。在本综述中，我们详细分析了所有可能解释这种心电图图形出现的情况，包括良性和病理性的。我们还提出了一种简单的心电图鉴别诊断算法。
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