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急性左主干冠状动脉闭塞的心电图表现被误诊为室性心动过速。

Electrocardiographic presentation of acute left main coronary artery occlusion misinterpreted as ventricular tachycardia.

机构信息

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

Department of Cardiology, Limassol General Hospital, Limassol, Cyprus.

出版信息

J Electrocardiol. 2021 Sep-Oct;68:7-10. doi: 10.1016/j.jelectrocard.2021.06.013. Epub 2021 Jul 2.

Abstract

We present a case of acute left main coronary artery (LMCA) occlusion that manifested cardiogenic shock and an ST-segment elevation myocardial infarction (STEMI) electrocardiographic (ECG) pattern comprising "triangular" or "lambda-like" QRS-ST-T complexes. The presenting ECG pattern was misinterpreted as ventricular tachycardia (VT) with resultant delayed emergency percutaneous coronary intervention. The patient died of intractable cardiogenic shock. This case corroborates previous research findings associating the ECG pattern comprising "triangular" or "lambda-like" QRS-ST-T complexes observed in the clinical setting of acute myocardial ischemia with acute LMCA occlusion. Also, we demonstrate how this ECG pattern should be scrutinized for ST-segment elevation in order to avoid misdiagnosing a STEMI for VT.

摘要

我们报告了一例急性左主干冠状动脉(LMCA)闭塞的病例,该病例表现为心源性休克和心电图(ECG)表现为“三角形”或“lambda 样”QRS-ST-T 复合体的 ST 段抬高型心肌梗死(STEMI)。呈现的 ECG 模式被错误地解释为室性心动过速(VT),导致紧急经皮冠状动脉介入治疗延迟。患者死于难治性心源性休克。该病例证实了先前的研究结果,即临床急性心肌缺血情况下观察到的“三角形”或“lambda 样”QRS-ST-T 复合体的 ECG 模式与急性 LMCA 闭塞有关。此外,我们展示了如何仔细检查该 ECG 模式以观察 ST 段抬高,以避免将 STEMI 误诊为 VT。

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