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变异型心绞痛伴自发性缺血和心动过速诱导的“λ”波。

Variant Angina with Spontaneously Documented Ischemia- and Tachycardia-induced "Lambda" Waves.

机构信息

Department of Community Emergency Medicine, Ehime University Graduate School of Medicine, Japan.

Department of Cardiology, Yawatahama City General Hospital, Japan.

出版信息

Intern Med. 2021;60(9):1409-1415. doi: 10.2169/internalmedicine.6197-20. Epub 2021 May 1.

DOI:10.2169/internalmedicine.6197-20
PMID:33952813
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8170254/
Abstract

In a patient with variant angina of the proximal left anterior descending coronary artery, myocardial ischemia changed the QRS-ST-T configurations without J-waves into those resembling "lambda" waves at maximal ST-segment elevation, and couplets or triplets of supraventricular extrasystole (SVE) changed the ischemia-induced "lambda" waves into QRS-ST-T configurations resembling a "tombstone" morphology or "monophasic QRS-ST complex." At the resolution phase of coronary spasm, the QRS-ST-T configurations returned to those without J-waves and were changed by SVE into "lambda" waves. Interestingly, neither ischemia- nor SVE-induced "lambda" waves or SVE-induced "tombstone" morphology or "monophasic QRS-ST complex" were complicated by ventricular tachyarrhythmia.

摘要

在近端左前降支变异型心绞痛患者中，心肌缺血使 QRS-ST-T 形态发生改变，无 J 波，类似于最大 ST 段抬高时的“λ”波，成对或成三联的室上性期前收缩（SVE）使缺血诱导的“λ”波转变为类似于“墓碑”形态或“单相 QRS-ST 复合体”的 QRS-ST-T 形态。在冠状动脉痉挛缓解期，QRS-ST-T 形态恢复至无 J 波，SVE 使“λ”波发生改变。有趣的是，缺血或 SVE 诱导的“λ”波或 SVE 诱导的“墓碑”形态或“单相 QRS-ST 复合体”均不伴有室性心动过速。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/94330412c2d4/1349-7235-60-1409-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/e445b47de0bc/1349-7235-60-1409-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/e53c08fc9bdc/1349-7235-60-1409-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/c4152c9cb06d/1349-7235-60-1409-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/9eef515f3088/1349-7235-60-1409-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/94330412c2d4/1349-7235-60-1409-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/e445b47de0bc/1349-7235-60-1409-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/e53c08fc9bdc/1349-7235-60-1409-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/c4152c9cb06d/1349-7235-60-1409-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/9eef515f3088/1349-7235-60-1409-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7cf/8170254/94330412c2d4/1349-7235-60-1409-g005.jpg

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Am J Cardiol. 2019 Apr 15;123(8):1262-1266. doi: 10.1016/j.amjcard.2019.01.015. Epub 2019 Jan 24.
2
Lambda-like ST-segment elevation in acute myocardial infarction triggered by coronary spasm may be a new risk predictor for lethal ventricular arrhythmia: A case report.冠状动脉痉挛引发的急性心肌梗死中类似λ波的ST段抬高可能是致死性室性心律失常的一种新的风险预测指标：一例病例报告。
Medicine (Baltimore). 2018 Dec;97(49):e13561. doi: 10.1097/MD.0000000000013561.
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The tetrafascicular nature of the intraventricular conduction system.
Premature atrial contractions with multiple patterns of aberrant conduction followed by torsade de pointes in a patient with polymyalgia rheumatica: A case report.
风湿性多肌痛患者出现多种形态的异常传导性房性早搏并扭转型室性心动过速：一例报告。
Medicine (Baltimore). 2021 Sep 17;100(37):e27286. doi: 10.1097/MD.0000000000027286.
心室内传导系统的四束状特性。
Clin Cardiol. 2019 Jan;42(1):169-174. doi: 10.1002/clc.23093. Epub 2018 Dec 13.
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Transient left septal fascicular block and left anterior fascicular block as a consequence of proximal subocclusion of the left anterior descending coronary artery.左前降支冠状动脉近端次全闭塞导致的短暂性左间隔束支阻滞和左前分支阻滞。
Ann Noninvasive Electrocardiol. 2019 May;24(3):e12546. doi: 10.1111/anec.12546. Epub 2018 Apr 19.
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Transient left septal fascicular block in the setting of acute coronary syndrome associated with giant slurring variant J-wave.急性冠状动脉综合征合并巨大顿挫型J波时出现的短暂性左间隔分支阻滞。
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