一名经皮冠状动脉介入治疗后同时出现前壁和下壁ST段抬高的患者。

A patient with simultaneous anterior and inferior ST-segment elevation after percutaneous coronary intervention.

作者信息

Andreou Andreas Y, Atieh Zeinab Al Hawraa, Pham Alisa Thuy Anh

机构信息

Department of Cardiology, Limassol General Hospital, Limassol, Cyprus; University of Nicosia Medical School, Nicosia, Cyprus.

University of Nicosia Medical School, Nicosia, Cyprus.

出版信息

J Electrocardiol. 2019 Nov-Dec;57:24-26. doi: 10.1016/j.jelectrocard.2019.08.014. Epub 2019 Aug 20.

DOI:10.1016/j.jelectrocard.2019.08.014

PMID:31473475

Abstract

A patient who presented with acute inferior-right ventricular (RV) ST-segment elevation (STE) myocardial infarction (MI) is described. Coronary angiography showed a mid-right coronary artery (RCA) occlusion and high-grade proximal left anterior descending (LAD) artery stenoses. Electrocardiography (ECG) after stent angioplasty to the RCA showed new STE in leads V1-V6. Whereas STE pattern recognition was misleading, ECG analysis using vector concepts enabled exclusion of anterior MI due to proximal LAD artery occlusion and recognition of the RV origin of this ECG picture. The ability of the ECG to "capture" RV dilation that enabled the manifestation of this ECG picture is highlighted.

摘要

本文描述了一名表现为急性下壁-右心室（RV）ST段抬高（STE）型心肌梗死（MI）的患者。冠状动脉造影显示右冠状动脉（RCA）中段闭塞及左前降支（LAD）动脉近端高度狭窄。对RCA进行支架血管成形术后的心电图（ECG）显示V1-V6导联出现新的ST段抬高。虽然ST段抬高模式识别具有误导性，但使用向量概念进行的ECG分析能够排除因LAD动脉近端闭塞导致的前壁心肌梗死，并识别出该ECG表现源自RV。强调了ECG“捕捉”RV扩张从而使该ECG表现得以显现的能力。