ST段压低上斜型：是急性缺血吗？
Upsloping ST depression: Is it acute ischemia?
作者信息
Alam Mahboob, Nikus Kjell, Fiol Miguel, Bayes de Luna Antoni, Birnbaum Yochai
机构信息
The Section of Cardiology, Baylor College of Medicine and Texas Heart Institute, Baylor St Luke Medical Center, Houston, Texas.
The Heart Center, Faculty of Medicine and Life Sciences, Tampere University Hospital, University of Tampere, Tampere, Finland.
出版信息
Ann Noninvasive Electrocardiol. 2019 May;24(3):e12607. doi: 10.1111/anec.12607. Epub 2018 Nov 2.
Abstract
We describe a patient with acute coronary syndrome, presenting with upsloping ST depression in leads I, II, V3-V6 and ST elevation in lead aVR. Coronary angiography revealed spontaneous dissection in a big, dominant left circumflex artery. No other lesions identified. During stenting of the dissection site, the distal left circumflex, supplying a large posterior descending artery was occluded, resulting in ST elevation myocardial infarction with ST elevation in lead III and aVF, but not II. This pattern is considered to represent right coronary artery infarction, rather than left circumflex infarction.
摘要
我们描述了一名患有急性冠状动脉综合征的患者，其心电图表现为 I、II、V3-V6 导联 ST 段压低呈上升型，aVR 导联 ST 段抬高。冠状动脉造影显示一支粗大的优势左旋支动脉自发夹层形成，未发现其他病变。在对夹层部位进行支架置入时，供应粗大后降支动脉的左旋支远端闭塞，导致 ST 段抬高型心肌梗死，表现为 III 导联和 aVF 导联 ST 段抬高，但 II 导联未出现 ST 段抬高。这种心电图表现被认为代表右冠状动脉梗死，而非左旋支梗死。
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