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右冠状动脉夹层期间的Brugada波拟表型

Brugada phenocopy during right coronary artery dissection.

作者信息

Carrizo Aldo G, Goransky Anahi, Baranchuk Adrian

机构信息

Cardiology Division, McMaster University, Hamilton, Ontario, Canada.

Department of Radiology, McMaster University, Hamilton, Ontario, Canada.

出版信息

J Electrocardiol. 2017 Nov-Dec;50(6):969-971. doi: 10.1016/j.jelectrocard.2017.07.005. Epub 2017 Jul 12.

Abstract

CASE PRESENTATION

A 68-year-old female presented with non-ST-segment elevation myocardial infarction, and urgency coronary angiography was performed. The procedure was complicated with right coronary artery dissection leading to type-1 Brugada ECG pattern.

DISCUSSION

Brugada phenocopies (BrP) are clinical entities that present with electrocardiograms identical to those found in Brugada Syndrome (BrS) but are the result of different medical conditions. This report provides evidence that atypical causes of myocardial ischemia may induce BrP. Appropriate electrocardiogram and clinical differentiation of Brugada phenocopy from true Brugada syndrome may prevent unnecessary treatments. Although patients with true high-risk BrS are candidates for ICD therapy, the natural history of BrP remains unknown and seems to be more benign, depending on the severity of the underlying condition.

摘要

病例报告

一名68岁女性因非ST段抬高型心肌梗死就诊,遂行急诊冠状动脉造影。该手术并发右冠状动脉夹层,导致1型Brugada心电图模式。

讨论

Brugada综合征拟表型(BrP)是指临床表现出与Brugada综合征(BrS)相同心电图特征,但由不同疾病引起的临床情况。本报告提供了证据表明,非典型心肌缺血原因可能诱发BrP。对Brugada综合征拟表型与真正的Brugada综合征进行恰当的心电图及临床鉴别,可避免不必要的治疗。虽然真正的高危BrS患者是植入式心律转复除颤器(ICD)治疗的候选对象,但BrP的自然病程仍不明确,且似乎更为良性,这取决于潜在疾病的严重程度。

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