Salem B I, Schnee M, Leatherman L L, de Castro C M, Benrey J
Am J Cardiol. 1978 Oct;42(4):681-5. doi: 10.1016/0002-9149(78)90641-0.
Two patients with a large posterior pericardial effusion after cardiac surgery presented with electrocardiographic precordial Q waves without evidence of myocardial infarction. Resolution of the pericardial fluid resulted in the disappearance of the Q waves. Changes in conductivity and orientation of the heart within the pericardial space, along with a decrease in QRS voltage, could lead to the loss of initial R waves in the precordial leads, eventually resulting in a QS complex. Care should be taken in interpreting the electrocardiogram after cardiac surgery in patients with a large posterior pericardial effusion. The clinical course along with serial electrocardiographic and echocardiographic tracings should be helpful in identifying this false infarction pattern.
两名心脏手术后出现大量心包后积液的患者表现出心电图胸前导联Q波，而无心肌梗死证据。心包积液消退后Q波消失。心包腔内心脏传导性和方位的改变，以及QRS电压降低，可能导致胸前导联初始R波丢失，最终形成QS波群。对于有大量心包后积液的心脏手术后患者，解读心电图时应谨慎。临床病程以及系列心电图和超声心动图检查结果有助于识别这种假梗死模式。
