Ginanjar Eka, Yulianto Yulianto
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo, Jakarta, Indonesia..
Acta Med Indones. 2017 Oct;49(4):347-350.
The purpose of this case repots are to evaluate the role of ST elevation in aVR lead and to make analysis between both cases. There are some atypical electrocardiogram (ECG) presentations which need prompt management in patient with ischemic clinical manifestation such as ST elevation in aVR lead. In this case study, we report a 68-year old woman with chief symptoms of shortness of breath and chest discomfort. She was diagnosed with cardiogenic shock, with Killip class IV, and TIMI score of 8. The second case is a 57-year-old man with typical chest pain at rest which could not be relieved with nitrate treatment. He was diagnosed with ST elevation in inferior and aVR lead, and occlusion in left circumflex artery (LCX). Both patients underwent primary percutaneous coronary intervention (PPCI). Subsequently, both cases presented remarkable clinical improvements and improved ST elevation myocardial infarction (STEMI) in aVR lead.
本病例报告的目的是评估aVR导联ST段抬高的作用,并对两例病例进行分析。存在一些非典型心电图表现,对于有缺血临床表现的患者,如aVR导联ST段抬高,需要及时处理。在本病例研究中,我们报告了一名68岁女性,主要症状为呼吸急促和胸部不适。她被诊断为心源性休克,Killip分级为IV级,TIMI评分8分。第二例是一名57岁男性,静息时出现典型胸痛,硝酸酯类治疗不能缓解。他被诊断为下壁和aVR导联ST段抬高,左回旋支(LCX)闭塞。两名患者均接受了直接经皮冠状动脉介入治疗(PPCI)。随后,两例患者的临床症状均有显著改善,aVR导联ST段抬高型心肌梗死(STEMI)情况也有所改善。