急性完全闭塞合并左前降支和右冠状动脉次全闭塞的心电图表现。
Electrocardiographic findings of acute total occlusion associated with a sub-occlusion involving the left anterior descending and the right coronary artery.
作者信息
Zhan Zhong-Qun, Li Yang-Hua, Li Yang, Li Jian-Ping, Nikus Kjell C
机构信息
Department of Cardiology, Shenzhen Hospital-University of Chinese Academy of Sciences, Guangming district, Shenzhen City, PR China.
Department of Cardiology, Shenzhen Hospital-University of Chinese Academy of Sciences, Guangming district, Shenzhen City, PR China.
出版信息
J Electrocardiol. 2019 Jul-Aug;55:107-110. doi: 10.1016/j.jelectrocard.2019.05.012. Epub 2019 May 21.
BACKGROUND
The ECG characteristics of simultaneous acute occlusion/sub-occlusion of two coronary arteries involving the left anterior descending (LAD) and right (RCA) coronary artery have been rarely described in the literature.
METHODS
We present two patient cases, where one of the arteries was totally occluded and the other one had a sub-occlusion with severely limited flow to demonstrate the ECG characteristics of this severe presentation of acute coronary syndrome.
RESULTS
Two ECG patterns suggested simultaneous occlusions of the RCA and LAD. One pattern was ST-segment elevation (STE) in lead III higher than in lead II with concomitant STE in leads V3-V4. The other pattern was STE in lead III higher than in lead II with the concomitant Dressler - de Winter ECG pattern in leads V2-V4.
CONCLUSIONS
We present two ECG presentations of simultaneous RCA and LAD occlusion/sub-occlusion. We consider these ECG features as high-risk markers in acute ST-elevation myocardial infarction.
背景
文献中很少描述涉及左前降支（LAD）和右冠状动脉（RCA）的两条冠状动脉同时急性闭塞/次闭塞的心电图特征。
方法
我们展示了两个病例，其中一条动脉完全闭塞，另一条动脉存在次闭塞且血流严重受限，以证明这种严重急性冠状动脉综合征表现的心电图特征。
结果
两种心电图模式提示RCA和LAD同时闭塞。一种模式是III导联ST段抬高（STE）高于II导联，同时V3 - V4导联伴有STE。另一种模式是III导联STE高于II导联，同时V2 - V4导联伴有德雷斯勒 - 德温特心电图模式。
结论
我们展示了RCA和LAD同时闭塞/次闭塞的两种心电图表现。我们认为这些心电图特征是急性ST段抬高型心肌梗死的高危标志物。
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