Kataoka H, Kanzaki K, Mikuriya Y
Second Department of Internal Medicine, Oita Medical College.
J Cardiol. 1988 Jun;18(2):541-51.
This is a report of right ventricular infarction complicated by inferior myocardial infarction in which marked ST-segment elevation was observed in the precordial and inferior leads. A 51-year-old man was admitted with chest pain of one-half hour duration. His admission ECG showed conspicuous ST-segment elevation in the precordial and inferior leads. The maximum magnitude of the ST-segment elevation in the precordial leads was 21 mm in lead V2 and 10 mm in lead II. Echocardiography showed akinesis of the right ventricular free wall and the posterior half of the left ventricle. Angiography revealed a 90% reduction in the diameter of the right coronary artery in its proximal portion, and a normal left coronary system. Recent reports have indicated that precordial ST-segment elevation may reflect right ventricular infarction. However, there has been no previous report of marked ST-segment elevation in the precordial and inferior leads. In right ventricular infarction, the currents of injury usually occur simultaneously in the right ventricular free wall and left ventricular inferior wall, and then are electrically opposed to each other. The diffuse and marked ST-segment elevation observed in this case is thus a rare phenomenon.
这是一份关于右心室梗死并发下壁心肌梗死的报告，在前胸导联和下壁导联观察到明显的ST段抬高。一名51岁男性因持续半小时的胸痛入院。其入院心电图显示前胸导联和下壁导联有明显的ST段抬高。前胸导联ST段抬高的最大幅度在V2导联为21mm，在II导联为10mm。超声心动图显示右心室游离壁和左心室后半部运动减弱。血管造影显示右冠状动脉近端直径减少90%，左冠状动脉系统正常。最近的报告表明，前胸导联ST段抬高可能反映右心室梗死。然而，此前尚无前胸导联和下壁导联明显ST段抬高的报告。在右心室梗死中，损伤电流通常同时出现在右心室游离壁和左心室下壁，然后彼此电对抗。因此，本病例中观察到的弥漫性和明显的ST段抬高是一种罕见现象。
